| NPI | 1841481603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DICK DRESANG Executive Director 307-577-5718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |