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Organization

PEACEFUL REHABILITATION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELODY LYNN CARTER MS, LPC, LAT (OWNER)
(307) 363-4720
Entity
Organization

Contact information

Practice address
113 S GILLETTE AVE, SUITE 210, GILLETTE, WY 82716-3740
(307) 363-4720
(307) 363-4722
Mailing address
822 N GURLEY AVE, 102, GILLETTE, WY 82716-2299
(307) 363-4720
(307) 363-4722

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
347
WY
101YP2500X
Professional Counselor
Primary
1395
WY

Other

Enumeration date
02/23/2015
Last updated
02/25/2015
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