| Wyoming Behavior Llc | |
|
212 E 22nd St Ste Mp Cheyenne WY 82001-3729 | |
| (718) 633-4411 | |
| Not Available |
| Full Name | Wyoming Behavior Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 212 E 22nd St Ste Mp, Cheyenne, Wyoming |
| Authorized Official Name and Position | Israel Benede (CEO) |
| Authorized Official Contact | 7186334411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Behavior Llc 6214 24th Ave Brooklyn NY 11204-3319 Ph: (718) 336-6073 | Wyoming Behavior Llc 212 E 22nd St Ste Mp Cheyenne WY 82001-3729 Ph: (718) 633-4411 |
| NPI Number | 1295507358 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295507358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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