| NPI | 1720857030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY ROBERT HUDSON Owner 307-209-4649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-28 |
| Last Update Date | 2023-12-28 |