| NPI | 1295286185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLEEN D MEADE Owner 307-234-9979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY LCSW 680) |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |