| NPI | 1447480561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA SISCO Revenue Cycle Manager 307-233-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2024-03-08 |