| NPI | 1750642526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA GOLDENSOHN Psychologist 307-733-8210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WY 3) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2022-07-21 |