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Organization
DUBOIS ASSISTED LIVING, INC
Active
Organization
DUBOIS ASSISTED LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA GREEN PHD, FNP-BC, (ADMINISTRATOR)
(307) 455-2645
Entity
Organization
Contact information
Practice address
5643 US HIGHWAY 26, DUBOIS, WY 82513-1839
(307) 455-2645
(307) 455-2647
Mailing address
PO BOX 1839, DUBOIS, WY 82513-1839
(307) 455-2645
(307) 455-2647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
P0713-106
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P0713-106
ASSISTED LIVING PROVISIONAL LICENSE NUMBER
WY
Enumeration date
01/16/2014
Last updated
01/16/2014
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