| NPI | 1962077701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ROBERTSON Owner 307-363-2705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |