# WYO RISE

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

## Provider details

- **NPI number:** 1790417293
- **Authorized official:** DIANE SERVANEZ (DIRECTOR)
- **Authorized official phone:** (720) 937-1880

## Contact information

- **Practice address:** 318 W 11TH AVE, TORRINGTON, WY 82240-3349
- **Practice address phone:** (720) 937-1880
- **Mailing address:** 318 W 11TH AVE, TORRINGTON, WY 82240-3349
- **Mailing address phone:** (720) 937-1880

## Taxonomy

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

## Other

- **Enumeration date:** 06/24/2022
- **Last updated:** 06/24/2022