Organization
B.A.C.A. CASE MANAGMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE BACA BSW (OWNER)
(307) 757-5868
Entity
Organization
Contact information
Practice address
6500 LONGABAUGH WAY, CHEYENNE, WY 82009-9699
(307) 757-5868
(866) 544-1882
Mailing address
6500 LONGABAUGH WAY, CHEYENNE, WY 82009-9699
(307) 757-5868
(866) 544-1882
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023499027
—
WY
05
—
141785100
—
WY
Enumeration date
05/12/2020
Last updated
05/12/2020
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