# FREMONT COUNTY GROUP HOMES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124593421
- **Authorized official:** DANA MARIE FLINT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (307) 856-2643

## Contact information

- **Practice address:** 11 MINTER LN, RIVERTON, WY 82501-8959
- **Practice address phone:** (307) 856-2643
- **Mailing address:** 11 MINTER LN, RIVERTON, WY 82501-8959
- **Mailing address phone:** (078) 562-6433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2018
- **Last updated:** 10/12/2018