Organization
WITH EAGLE'S WINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON EDWARD WAKEFIELD EDD (EXECUTIVE DIRECTOR)
(307) 857-5940
Entity
Organization
Contact information
Practice address
11 GREAT PLAIN ROAD, ARAPAHOE, WY 82524-0197
(307) 857-5940
(307) 857-5932
Mailing address
PO BOX 197, ST STEPHENS, WY 82524-0197
(307) 857-5940
(307) 857-5932
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
WY
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
06/01/2007
Last updated
08/23/2007
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