Organization
BOYS & GIRLS CLUB OF EVANSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY SLADE (CEO)
(307) 444-2582
Entity
Organization
Contact information
Practice address
419 4TH ST, EVANSTON, WY 82930-3616
(307) 444-2582
Mailing address
419 4TH ST, EVANSTON, WY 82930-3616
(307) 444-2582
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
WY
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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