| NPI | 1881730141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARD KLEIN COO 307-688-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2025-04-07 |