| NPI | 1770302663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE PETERSON CEO 307-840-3594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| 1041C0700X Social Worker Clinical | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2025-02-03 |