Organization
MARY JEAN MEDINA
Active
Other names
Abilities Unlimited
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JEAN MEDINA (ADMINISTRATOR)
(307) 837-2155
Entity
Organization
Contact information
Practice address
221 MAIN ST., LINGLE, WY 82223-0363
(307) 837-2155
(978) 285-0404
Mailing address
PO BOX 363, LINGLE, WY 82223-0363
(307) 837-2155
(978) 285-0404
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118921200
—
WY
Enumeration date
02/05/2007
Last updated
06/19/2008
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