| NPI | 1285064386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE STRAWN Owner 307-685-6982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: WY 101YP2500X) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WY 101YP2500X) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WY 101YP2500X) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2013-11-26 |