| NPI | 1417469115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L VASA Mental Health Clinician 307-389-8044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 10492016-3501) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-14 |