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Organization
MOUNTAIN REGIONAL SERVICES, INC.
Active
Organization
MOUNTAIN REGIONAL SERVICES, INC.
Active
Other names
Cornerstone Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOLDEREGGER MA (CEO)
(307) 789-3710
Entity
Organization
Contact information
Practice address
50 ALLEGIANCE CIR, EVANSTON, WY 82930-3804
(307) 789-3710
(307) 789-0823
Mailing address
PO BOX 6005, EVANSTON, WY 82931-6005
(307) 789-3710
(307) 789-0823
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118767800
—
WY
Enumeration date
05/25/2007
Last updated
10/29/2009
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