| NPI | 1770476491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LEE HAMBLIN Owner 307-871-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-06-02 |
| Last Update Date | 2025-06-02 |