| NPI | 1649016486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GONZALEZ Ar Supervisor 307-352-6677 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-07-02 |