| NPI | 1578685863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS DONOHUE Executive Director 307-733-8210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |