NPI 1750642526

Region V Boces

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Wilson, WY

Practice location

Address: 3850 N. Wilderness Dr., Wilson, WY 83014
Phone: (307) 733-8210
Fax: (307) 733-8462
Mailing address: PO Box 240, Wilson, WY 83014-0240

Authorised official

Name: Julia Goldensohn
Title: Psychologist
Phone: (307) 733-8210

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 3 (WY)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Wyoming →

Registry record

NPI: 1750642526
Entity type: Organization
NPI issued: 7 Jun 2012
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.