| NPI | 1942458195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY BETH BERTONCELJ Executive Director 307-686-1189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2010-10-18 |