Provider Demographics
NPI:1699816843
Name:CHEYENNE HABILITATION & THERAPEUTIC CENTER, INC
Entity Type:Organization
Organization Name:CHEYENNE HABILITATION & THERAPEUTIC CENTER, INC
Other - Org Name:CHAT CENTER, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ELFERING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-433-1110
Mailing Address - Street 1:1616 E 19TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4946
Mailing Address - Country:US
Mailing Address - Phone:307-433-1110
Mailing Address - Fax:307-433-1114
Practice Address - Street 1:1616 E 19TH ST STE 4
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4946
Practice Address - Country:US
Practice Address - Phone:307-433-1110
Practice Address - Fax:307-433-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services