MEDICARE: NORTHWEST COMMUNITY ACTION PROGRAMS OF WYOMING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1881714210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST COMMUNITY ACTION PROGRAMS OF WYOMING, INC.

Provider Business Mailing Address
First Line	:	345 N WALSH DR
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-1941
Country	:	US
Telephone Number	:	307-237-9146
Fax Number	:	307-234-1029

Provider Business Practice Location Address
First Line	:	345 N WALSH DR
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-1941
Country	:	US
Telephone Number	:	307-237-9146
Fax Number	:	307-234-1029

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DAWN LACKO
Credential	:
Telephone Number	:	307-257-9146

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	01/23/2026

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