Healthcare Provider Details

I. General information

NPI: 1750297677
Provider Name (Legal Business Name): STANDARDS HABILITATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 S DOUGLAS HWY UNIT 3
GILLETTE WY
82718-6557
US

IV. Provider business mailing address

1214 SHIP WHEEL LN
GILLETTE WY
82716-4829
US

V. Phone/Fax

Practice location:
  • Phone: 307-622-6520
  • Fax:
Mailing address:
  • Phone: 307-622-6520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MANDILEE LOCKE
Title or Position: OWNER
Credential:
Phone: 307-622-6520