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General NPI Number Information
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NPI Number | 1750730339
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Entity Type | Organization
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Legal Business Name | CARITAS MENTAL HEALTH LLC
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 5204 RAVEN ST
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City | GILLETTE
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State | WY
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Zip | 82718
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Country | US
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Telephone | 989-884-2310
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Fax |
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Provider Business Mailing Address
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Address Line | 5204 RAVEN ST
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City | GILLETTE
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State | WY
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Zip | 82718
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | SHARI D FROELICH
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Credential | DNP
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Telephone | 989-884-2310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | WY
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