Organization
S48WY4, LLC
Active
Parent organization
S48WY1, LLC
Other names
Wyoming Recovery Rawlins
Organization subpart
Yes
Provider details
NPI number
Legal business name
S48WY1, LLC
Authorized official
AMANDA CONSTANTINO (HUMAN RESOURCES)
(307) 265-3791
Entity
Organization
Contact information
Practice address
606 23RD ST, RAWLINS, WY 82301-5127
(307) 324-8820
(307) 333-0261
Mailing address
606 23RD ST, RAWLINS, WY 82301-5127
(307) 324-8820
(307) 333-0261
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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