| NPI | 1891527057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL D NELSON Founder/Director 307-251-1852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |