| NPI | 1265751309 |
|---|---|
| Other Name | EASTERN SHOSHONE TRIBE |
| Entity Type | Organization |
| Authorized Contact | KELLIE R WEBB Recovery Program Director 307-335-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2016-05-31 |