Organization
S48WY4, LLC
Active
Parent organization
S48WY1, LLC
Other names
Crossroads Counseling Solutions
Organization subpart
Yes
Provider details
NPI number
Legal business name
S48WY1, LLC
Authorized official
MS. LYNN THOMPSON (PRESIDENT)
(307) 265-3791
Entity
Organization
Contact information
Practice address
606 23RD ST, RAWLINS, WY 82301-5127
(307) 342-8820
(307) 333-0261
Mailing address
606 23RD ST, RAWLINS, WY 82301-5127
(307) 342-8820
(307) 333-0261
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
172V00000X
Community Health Worker
—
—
2084P0800X
Psychiatry Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149784700
—
WY
Enumeration date
03/28/2018
Last updated
09/12/2019
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