| NPI | 1295379865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIPP DANA Executive Director 307-885-9883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2023-03-10 |