Organization
ELEVATE WYOMING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR B EDGCOMB MA (CO-OWNER, FAMILY CARE COORDINATOR)
(307) 620-2008
Entity
Organization
Contact information
Practice address
3 JANICH LN, SHERIDAN, WY 82801-8600
(307) 763-6987
Mailing address
3 JANICH LN, SHERIDAN, WY 82801-8600
(307) 683-6987
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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