| NPI | 1376688580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDA MEYER Executive Director 307-532-4197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: WY 5405I) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WY 5405 I) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-12-14 |