| NPI | 1477929560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBIE R CAMBLIN Ppc 307-431-7350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY PPC-761) |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2016-11-28 |