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Organization

S48WY4, LLC

Active
Parent organization
WYOMING RECOVERY
Other names
Wyoming Recovery of Rawlins
Organization subpart
Yes

Provider details

NPI number
Legal business name
WYOMING RECOVERY
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
Mailing address
231 S WILSON ST, CASPER, WY 82601-2941
(307) 265-3791

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
01/27/2021
Last updated
01/27/2021
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