| NPI | 1629294228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL H FAULKNER Chief Executive Director 307-638-4092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |