| NPI | 1427499003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA JOLENE BELLAR Owner/Manager 307-421-6635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 0011530) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2016-02-22 |