Provider Demographics
NPI:1881714210
Name:NORTHWEST COMMUNITY ACTION PROGRAMS OF WYOMING, INC.
Entity type:Organization
Organization Name:NORTHWEST COMMUNITY ACTION PROGRAMS OF WYOMING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENATE
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-237-9146
Mailing Address - Street 1:345 N WALSH DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-1941
Mailing Address - Country:US
Mailing Address - Phone:307-237-9146
Mailing Address - Fax:307-234-1029
Practice Address - Street 1:345 N WALSH DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-1941
Practice Address - Country:US
Practice Address - Phone:307-237-9146
Practice Address - Fax:307-234-1029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services