| NPI | 1376350520 |
|---|---|
| Former Legal Business Name | WYOMING FUNDAMENTAL HEALING AND RECOVERY LLC |
| Entity Type | Organization |
| Authorized Contact | ROBERT JAY BARNOSKY Owner 307-472-3769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |