Organization
ALPHA OMEGA DD SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA DESIREE NORRIS RN (PRESIDENT)
(307) 267-4172
Entity
Organization
Contact information
Practice address
1180 S LOCUST ST, CASPER, WY 82604-2875
(307) 267-4172
Mailing address
911 PEBBLE MOUNTAIN DR, MILLS, WY 82604-8913
(307) 267-4172
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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