| NPI | 1629379037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM V TORRANCE Director 307-660-8581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WY 129269200) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |