NPI | 1700194420 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEECE GUTIERREZ Owner 307-237-0656 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY 2010-000588996) |
Enumeration Date | 2010-09-15 |
Last Update Date | 2010-09-15 |