Provider Demographics
NPI:1306203047
Name:MICHELLE L CROFT
Entity Type:Organization
Organization Name:MICHELLE L CROFT
Other - Org Name:LIFT INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-272-7588
Mailing Address - Street 1:440 NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELL
Mailing Address - State:WY
Mailing Address - Zip Code:82431-1916
Mailing Address - Country:US
Mailing Address - Phone:307-272-7588
Mailing Address - Fax:
Practice Address - Street 1:440 NEVADA AVE
Practice Address - Street 2:
Practice Address - City:LOVELL
Practice Address - State:WY
Practice Address - Zip Code:82431-1916
Practice Address - Country:US
Practice Address - Phone:307-272-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty