Organization
VOLUNTEERS OF AMERICA NORTHERN ROCKIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BUCKINGHAM (VP OF IT AND COMPLIANCE)
(307) 672-0475
Entity
Organization
Contact information
Practice address
1221 W 5TH ST, SHERIDAN, WY 82801-2701
(307) 674-4405
(307) 673-5167
Mailing address
521 W LOTT ST, BUFFALO, WY 82834-1642
(307) 751-7440
(307) 673-5167
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106078308
—
WY
Enumeration date
10/18/2011
Last updated
04/01/2023
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