| NPI | 1912487208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA KIETELL Owner/CEO 307-369-4710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2025-11-21 |