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General NPI Number Information
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NPI Number | 1265751309
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Entity Type | Organization
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Legal Business Name | DOYA NATSU HEALING CENTER- EASTERN SHOSHONE TRIBE
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | #7 SHIPTON LANE
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City | FORT WASHAKIE
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State | WY
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Zip | 82514-0538
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Country | US
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Telephone | 307-335-1169
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Fax | 307-335-1170
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Provider Business Mailing Address
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Address Line | PO BOX 538
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City | FORT WASHAKIE
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State | WY
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Zip | 82514-0538
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Country | US
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Telephone | 307-335-1169
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Fax | 307-335-1170
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Authorized Official
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Title or Position | RECOVERY PROGRAM DIRECTOR
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Name | KELLIE R WEBB
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Credential | BS
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Telephone | 307-335-1169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | WY
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