| NPI | 1790067031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIPP DANA Executive Director 307-885-9883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WY LAT-220) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 207Q00000X Family Medicine | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2022-06-08 |