| NPI | 1386007888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL NELSON Owner 307-760-4128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY LCSW-779) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |