# DARE TO LIVE , LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dare to Live, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164133492
- **Authorized official:** JENEIL BOLES (OWNER)
- **Authorized official phone:** (307) 277-7352

## Contact information

- **Practice address:** 8700 W POISON SPIDER RD, CASPER, WY 82604-9507
- **Practice address phone:** (307) 277-7352
- **Mailing address:** 8700 W POISON SPIDER RD, CASPER, WY 82604-9507

## Taxonomy

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

## Other

- **Enumeration date:** 12/07/2022
- **Last updated:** 12/07/2022