| NPI | 1861624678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN MICHELLE DECASTRO Owner 307-259-3467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: WY 18154.0972) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2012-04-26 |