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Contact Information

EARLY INTERVENTION PROGRAM
9 SHIPTON LANE
FORT WASHAKIE, WY82514-0610
 Phone: 307-332-3516
 Fax: 307-332-9116
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Early Intervention Provider Agency

252Y00000X
Indicates primary specialty

NPI Profile & details for EARLY INTERVENTION PROGRAM

NPI Number 1831581719
LBN Legal business name EARLY INTERVENTION PROGRAM
Authorized official LAURENE HINES - (ASSISTANT DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/02/2015
Last updated 04/28/2017 - About 9 years ago
Identifiers
WY License # 129040100
WY Medicaid 129040100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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