Provider Demographics
NPI:1831389584
Name:SOL DOMUS, INC.
Entity type:Organization
Organization Name:SOL DOMUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-687-1100
Mailing Address - Street 1:1711 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-5567
Mailing Address - Country:US
Mailing Address - Phone:307-687-1100
Mailing Address - Fax:307-685-8249
Practice Address - Street 1:2805 CEDAR AVE STE B
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-2000
Practice Address - Country:US
Practice Address - Phone:307-687-1100
Practice Address - Fax:307-685-8249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services