Van Vleck House | |
510 S. Cache Dr. Jackson WY 83001-2631 | |
(307) 733-6440 | |
Not Available |
Full Name | Van Vleck House |
---|---|
Speciality | Community/behavioral Health |
Location | 510 S. Cache Dr., Jackson, Wyoming |
Authorized Official Name and Position | Cindy Knight (DIRECTOR) |
Authorized Official Contact | 3077336440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Van Vleck House Po Box 2631 510 S. Cache Jackson WY 83001-2631 Ph: (307) 733-6440 | Van Vleck House 510 S. Cache Dr. Jackson WY 83001-2631 Ph: (307) 733-6440 |
NPI Number | 1720288491 |
---|---|
Provider Enumeration Date | 07/20/2007 |
Last Update Date | 07/20/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720288491 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | LMFT-045 (Wyoming) | Primary |
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