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General NPI Number Information
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NPI Number | 1750730602
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Entity Type | Organization
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Legal Business Name | COMMUNITY CASE MANAGEMENT INC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 112 ALECIAS WAY
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City | EVANSTON
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State | WY
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Zip | 82930-6701
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Country | US
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Telephone | 307-371-9465
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Fax | 307-222-5124
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Provider Business Mailing Address
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Address Line | 112 ALECIAS WAY
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City | EVANSTON
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State | WY
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Zip | 82930-6701
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Country | US
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Telephone | 307-371-9465
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Fax | 307-222-5124
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Authorized Official
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Title or Position | PRESIDENT
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Name | WENDY DUMONT
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Credential | RN, BSN
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Telephone | 307-371-9465
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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 | WY
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