| NPI | 1386780427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK M BURDEN Executive Director 307-836-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |