Organization
ICBM INC
Active
Other names
ARC of Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELINA CHERNYAK DO (MEDICAL DIRECTOR)
(970) 306-2737
Entity
Organization
Contact information
Practice address
1501 RED TAIL DR, ROCK SPRINGS, WY 82901-5879
(307) 362-6029
(307) 362-2379
Mailing address
126 ELK ST, ROCK SPRINGS, WY 82901-5241
(307) 362-6029
(307) 362-2379
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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