| NPI | 1396578902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA M NEWMAN COO 307-444-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-08-21 |