| NPI | 1801662598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE MARIE CREASER Ownder 307-351-3666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2024-02-27 |