NPI | 1467123984 |
---|---|
Entity Type | Organization |
Authorized Contact | SHEILA NEWMAN Operations Manager 307-789-4224 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
207Q00000X Family Medicine | |
207QA0401X Family Medicine, Addiction Medicine | |
Enumeration Date | 2021-09-23 |
Last Update Date | 2023-03-02 |