Healthcare Provider Details

I. General information

NPI: 1588868707
Provider Name (Legal Business Name): CURRAN SEELEY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W. BROADWAY SUITE L1
JACKSON WY
83001
US

IV. Provider business mailing address

PO BOX 11390
JACKSON WY
83002-1390
US

V. Phone/Fax

Practice location:
  • Phone: 307-733-3908
  • Fax: 307-734-0017
Mailing address:
  • Phone: 307-733-3908
  • Fax: 307-734-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateWY

VIII. Authorized Official

Name: AUTUMN MEEKS
Title or Position: BOOKKEEPER
Credential:
Phone: 307-733-3908