| NPI | 1275834467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY TONN Principal 307-686-0231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist Clinical | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |