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Contact Information

JACKSON HOLE BEHAVIORAL SERVICES, LLC
1050 N 3RD ST
LARAMIE, WY82072-2544
 Phone: 715-829-5195
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Early Intervention Provider Agency

252Y00000X
Indicates primary specialty

NPI Profile & details for JACKSON HOLE BEHAVIORAL SERVICES, LLC

NPI Number 1881071355
LBN Legal business name JACKSON HOLE BEHAVIORAL SERVICES, LLC
Authorized official BRAD DICKEY - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/04/2015
Last updated 10/05/2022 - About 4 years ago
Identifiers
License # 1-12-11844
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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