| NPI | 1720401383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA CHANDLER Director 307-586-3725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-04-29 |