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General NPI Number Information
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NPI Number | 1407939218
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Entity Type | Organization
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Legal Business Name | ARK REGIONAL SERVICES, INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 1150 N 3RD STREET
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City | LARAMIE
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State | WY
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Zip | 82072
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Country | US
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Telephone | 307-742-6641
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Fax | 307-742-9203
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Provider Business Mailing Address
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Address Line | 1150 N 3RD STREET
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City | LARAMIE
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State | WY
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Zip | 82072-2514
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Country | US
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Telephone | 307-742-6641
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Fax | 307-742-9203
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Authorized Official
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Title or Position | VP - FINANCE
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Name | LEROY MARTIN
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Credential |
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Telephone | 307-742-6641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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