Provider Demographics
NPI:1629352406
Name:BIG HORN BASIN COUNSELING SERVICES
Entity Type:Organization
Organization Name:BIG HORN BASIN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT I.
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-548-6543
Mailing Address - Street 1:1114 LANE 12
Mailing Address - Street 2:
Mailing Address - City:LOVELL
Mailing Address - State:WY
Mailing Address - Zip Code:82431-9555
Mailing Address - Country:US
Mailing Address - Phone:307-548-6543
Mailing Address - Fax:307-548-6565
Practice Address - Street 1:1114 LANE 12
Practice Address - Street 2:
Practice Address - City:LOVELL
Practice Address - State:WY
Practice Address - Zip Code:82431-9555
Practice Address - Country:US
Practice Address - Phone:307-548-6543
Practice Address - Fax:307-548-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder