| NPI | 1386819308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY JANE LILEY Business Manager 307-637-8869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 103TC0700X Psychologist, Clinical | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2015-11-17 |