| NPI | 1477144160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CONSTANTINO Human Resources 307-265-3791 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2021-01-27 |