| NPI | 1306845920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BUCKINGHAM VP Of It And Compliance 307-672-0475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2022-04-12 |