Organization
REGION V BOARD OF COOPERATIVE EDUCATIONAL SERVICES
Active
Other names
C-V Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAYLING H SUMICAD OTR/L (OCCUPATIONAL THERAPIST)
(307) 733-8210
Entity
Organization
Contact information
Practice address
3850 NORTH WILDERNESS DRIVE, WILSON, WY 83025
(307) 733-8210
(307) 733-8462
Mailing address
PO BOX 240, WILSON, WY 83014-0240
(307) 733-8210
(307) 733-8462
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
OTR598
WY
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
OTR598
WY
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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