| NPI | 1891432118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY H WILLIAMS Provider/Owner 307-201-0372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2023-02-15 |