| NPI | 1790506632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY JINDRICK THOLL Owner 307-277-7214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-23 |