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Organization
WYO RISE
Active
Organization
WYO RISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SERVANEZ (DIRECTOR)
(720) 937-1880
Entity
Organization
Contact information
Practice address
318 W 11TH AVE, TORRINGTON, WY 82240-3349
(720) 937-1880
Mailing address
318 W 11TH AVE, TORRINGTON, WY 82240-3349
(720) 937-1880
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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