Provider Demographics
NPI:1760615090
Name:COMMUNITY ENTRY SERVICES
Entity Type:Organization
Organization Name:COMMUNITY ENTRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-856-5576
Mailing Address - Street 1:2441 PECK AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-2272
Mailing Address - Country:US
Mailing Address - Phone:307-856-5576
Mailing Address - Fax:307-857-6901
Practice Address - Street 1:2441 PECK AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2272
Practice Address - Country:US
Practice Address - Phone:307-856-5576
Practice Address - Fax:307-857-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management