Provider Demographics
NPI:1629121330
Name:COMMUNITY ACTION PARTNERSHIP OF NATRONA COUNTY
Entity Type:Organization
Organization Name:COMMUNITY ACTION PARTNERSHIP OF NATRONA COUNTY
Other - Org Name:HEALTHCARE FOR THE HOMELESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EICKHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-232-0124
Mailing Address - Street 1:800 WERNER CT., STE 201
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601
Mailing Address - Country:US
Mailing Address - Phone:304-232-0124
Mailing Address - Fax:307-232-0145
Practice Address - Street 1:1514 E 12TH ST.
Practice Address - Street 2:STE. 201
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601
Practice Address - Country:US
Practice Address - Phone:307-235-6116
Practice Address - Fax:307-235-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2016-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X, 261QF0400X
WY261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY11937300Medicaid
WY119137301OtherWY BREAST AND CERVICAL
WY119137300Medicaid
WY119137300Medicaid