| NPI | 1760925838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE FOX Clinical Director 307-265-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY LPC1609) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |