Organization
LINCOLN SELF RELIANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREL G SKINNER MSW (EXECUTIVE DIRECTOR)
(307) 885-1577
Entity
Organization
Contact information
Practice address
1038 SOUTH WASHINGTON, AFTON, WY 83110-1449
(307) 885-1577
(307) 885-2577
Mailing address
PO BOX 1449, 1038 SOUTH WASHINGTON, AFTON, WY 83110-1449
(307) 885-1577
(307) 885-2577
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
116099100
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116099100
—
WY
Enumeration date
01/23/2007
Last updated
06/23/2020
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