| NPI | 1770076614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BARTH Owner 307-640-7720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WY 658) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2020-03-16 |