Organization
LUCY RUSSELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY G. RUSSELL (OWNER)
(307) 632-0284
Entity
Organization
Contact information
Practice address
1748 HACKAMORE RD, CHEYENNE, WY 82009-1226
(307) 632-0284
(307) 778-3944
Mailing address
1748 HACKAMORE RD, CHEYENNE, WY 82009-1226
(307) 632-0284
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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