Organization
HOMETOWN FREEDOM HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENEDINA VASCO C-NP (EMPLOYEE, OWNER)
(307) 463-0541
Entity
Organization
Contact information
Practice address
705 E WASHINGTON AVE, RIVERTON, WY 82501-4452
(307) 463-0541
(307) 463-0494
Mailing address
705 E WASHINGTON AVE, RIVERTON, WY 82501-4452
(307) 463-0541
(307) 463-0494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
06/28/2022
Last updated
08/30/2023
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