| NPI | 1619097755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH MILATZO-JENSEN Director Of Administration 307-778-7832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WY 1633R) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WY 1633R) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |