Organization
TETON YOUTH & FAMILY SERVICES- RED TOP MEADOWS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE BURKLAND (EXECUTIVE DIRECTOR)
(307) 733-9098
Entity
Organization
Contact information
Practice address
7905 S. FALL CREEK ROAD, BOX 290, WILSON, WY 83014-0290
(307) 733-9098
(307) 733-7672
Mailing address
PO BOX 290, WILSON, WY 83014-0290
(307) 733-9098
(307) 733-7672
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PPC-892
WY
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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