| NPI | 1477008183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MCNIVEN Director 307-272-9224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WY LPC-860) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WY LPC-860) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |