Jciloa
NPI #1366108425 in Douglas, Wyoming
Provider Information
- NPI Number
- 1366108425
- Entity Type
- Organization
- Organization Name
- Jciloa
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Nov 12, 2021
- Last Updated
- Jul 2, 2022
Practice Location
Authorized Official
- Name
- EDWARD MICHAEL TUCKER
- Title
- OWNER
- Phone
- (307) 331-3703
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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