Provider Demographics
| NPI: | 1003301904 |
|---|---|
| Name: | CATHEDRAL HOME FOR CHILDREN |
| Entity type: | Organization |
| Organization Name: | CATHEDRAL HOME FOR CHILDREN |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | NICOLE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HAUSER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MSW, LCSW |
| Authorized Official - Phone: | 307-745-8997 |
| Mailing Address - Street 1: | 4989 N 3RD ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | LARAMIE |
| Mailing Address - State: | WY |
| Mailing Address - Zip Code: | 82072-9548 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 307-745-8997 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4989 N 3RD ST |
| Practice Address - Street 2: | |
| Practice Address - City: | LARAMIE |
| Practice Address - State: | WY |
| Practice Address - Zip Code: | 82072-9548 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 307-745-8997 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-06-25 |
| Last Update Date: | 2025-09-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | ||
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | Group - Multi-Specialty |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 2084B0040X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | Group - Multi-Specialty |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NE | 10026747700 | Medicaid | |
| WY | 83-069092 | Medicaid |