Organization
VOLUNTEERS OF AMERICA NORTHERN ROCKIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BUCKINGHAM (VP OF IT AND COMPLIANCE)
(307) 672-0475
Entity
Organization
Contact information
Practice address
420 DEANNE AVE, NEWCASTLE, WY 82701-2936
(307) 746-4456
(307) 746-4470
Mailing address
420 DEANNE AVE, NEWCASTLE, WY 82701-2936
(307) 746-4456
(307) 746-4470
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106074107
—
WY
Enumeration date
10/06/2011
Last updated
04/01/2023
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