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Organization

VOLUNTEERS OF AMERICA NORTHERN ROCKIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY BUCKINGHAM (VP OF IT AND COMPLIANCE)
(307) 684-5531
Entity
Organization

Contact information

Practice address
420 1/2 MAIN ST, SUNDANCE, WY 82729
(307) 283-3636
(307) 283-2898
Mailing address
521 W LOTT ST, BUFFALO, WY 82834-1642
(307) 751-7440
(307) 283-2898

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
106076707
WY
Enumeration date
10/10/2011
Last updated
04/01/2023
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