Healthcare Provider Details

I. General information

NPI: 1316120140
Provider Name (Legal Business Name): THE CENTER FOR ABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2007
Last Update Date: 12/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 CODY AVE
CASPER WY
82604-3151
US

IV. Provider business mailing address

1537 CODY AVE
CASPER WY
82604-3151
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-9565
  • Fax: 307-265-9565
Mailing address:
  • Phone: 307-265-9565
  • Fax: 307-265-9565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateWY

VIII. Authorized Official

Name: AMBER TRIMBLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 307-265-9565