| NPI | 1588868707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN MEEKS Bookkeeper 307-733-3908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2022-03-22 |