# GRAND TETON HEALING CENTER INC

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

## Provider details

- **NPI number:** 1609020254
- **Authorized official:** DR. GENE SLOCUM MD (DOCTOR/OWNER)
- **Authorized official phone:** (303) 949-1292

## Contact information

- **Practice address:** 5715 E 2ND ST, CASPER, WY 82609-4322
- **Practice address phone:** (303) 949-1292
- **Mailing address:** 5008 WEDGEWOOD DRIVE, BELLAIRE, TX 77401
- **Mailing address phone:** (281) 833-3330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | TL \#1019 | WY | Yes |

## Other

- **Enumeration date:** 11/10/2008
- **Last updated:** 02/04/2010