| NPI | 1730201120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON MAX MICKELSON Owner 307-875-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |