Healthcare Provider Details

I. General information

NPI: 1003954892
Provider Name (Legal Business Name): WESTON COUNTY CHILDREN'S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 STAMPEDE ST
NEWCASTLE WY
82701-3037
US

IV. Provider business mailing address

104 STAMPEDE ST
NEWCASTLE WY
82701-3037
US

V. Phone/Fax

Practice location:
  • Phone: 307-746-3541
  • Fax: 307-746-9417
Mailing address:
  • Phone: 307-746-3541
  • Fax: 307-746-9417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANE A RHOADES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 307-746-3541