| NPI | 1962447375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RANSOM CFO 307-587-2197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2015-10-26 |