| NPI | 1457173031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JAMES BENNETT Owner/Director 307-254-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-10-25 |
| Last Update Date | 2024-10-25 |