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General NPI Number Information
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NPI Number | 1811102536
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Entity Type | Organization
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Legal Business Name | BUFFALO SENIOR CENTER, INC.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 671 W FETTERMAN ST
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City | BUFFALO
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State | WY
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Zip | 82834-2340
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Country | US
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Telephone | 307-684-9665
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 941
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City | BUFFALO
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State | WY
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Zip | 82834-0941
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Country | US
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Telephone | 307-684-9665
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BOBBIE J. WALSETH
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Credential | BSW
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Telephone | 307-684-9551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | WY
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