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General NPI Number Information
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NPI Number | 1386332492
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Entity Type | Organization
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Legal Business Name | PRECISE MIND BEHAVIORAL LLC
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 219 E PINE ST STE 203
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City | PINEDALE
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State | WY
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Zip | 82941-5420
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Country | US
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Telephone | 307-231-5472
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 687 PMB 175
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City | PINEDALE
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State | WY
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Zip | 82941
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Country | US
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Telephone | 307-231-5472
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Fax |
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Authorized Official
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Title or Position | AR/ BILLING ACCOUNT MANAGER
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Name | MRS. CRYSTAL THOMPSON
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Credential |
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Telephone | 307-231-5472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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