Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health, Federal |
261QP0904X | |||
Federally Qualified Health Center (FQHC) |
261QF0400X | B4[14] | Federally Qualified Health Center |
| NPI # | 1699292391 |
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| LBN Legal business name | WIND RIVER CARES RIVERTON | ||||
| Authorized official | RICHARD BRANNAN - (CEO) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 08/24/2017 | ||||
| Last updated | 05/03/2024 - About 2 years ago | ||||
| Identifiers |
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