| NPI | 1376147876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRBIE BROWN Owner 307-314-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2022-11-29 |