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General NPI Number Information
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NPI Number | 1679136766
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Entity Type | Organization
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Legal Business Name | SHILOH CASE MANAGEMENT LLC
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 04/15/2019
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Provider Practice Location Address
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Address Line | 730 W 51ST ST
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City | CASPER
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State | WY
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Zip | 82601-6337
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Country | US
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Telephone | 307-315-3651
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Fax |
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Provider Business Mailing Address
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Address Line | 730 W 51ST ST
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City | CASPER
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State | WY
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Zip | 82601-6337
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Country | US
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Telephone | 307-315-3651
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Fax |
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Authorized Official
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Title or Position | MSW/OWNER
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Name | MS. RACHAEL CLARK
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Credential | MSW
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Telephone | 307-315-3651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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