Organization
HOSPICE ALLIANCE OF WYOMING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN LARSEN (OWNER/CEO)
(435) 753-0707
Entity
Organization
Contact information
Practice address
878 N. WASHINGTON ST., AFTON, WY 83310-9770
(307) 885-7583
(307) 885-7585
Mailing address
965 S 100 W, SUITE 204, LOGAN, UT 84321-6062
(435) 753-0707
(435) 755-8505
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
07-156
WY
Other
Enumeration date
08/24/2006
Last updated
08/22/2020
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