National Provider Identifier Database

CANDICE R GRONBERG
Respite Care, Intellectual and/or Developmental Disabilities

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.


Contact Information

CANDICE R GRONBERG
4 ROBERTS ROAD
LANDER, WY82520-1401
Phone: 307-332-9122
Fax: 307-332-9122
Website:
Specialty Taxonomy Code
* Respite Care, Intellectual and/or Developmental Disabilities 385HR2060X

* Indicates primary specialty

NPI Profile & details for CANDICE R GRONBERG

NPI Number 1356632087
Credentials
Entity Individual
Enumeration date 04/28/2011
Last updated 04/28/2011 - About 15 years ago
Sole proprietor1 Yes
Identifiers
  • WY License #: 114858300
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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