| NPI | 1639915739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY CONGER Executive Director 307-789-7915 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |