| NPI | 1619709474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBI BARRETT Controller 307-332-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |