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Contact Information

S48WY4, LLC
606 23RD ST
RAWLINS, WY82301-5127
 Phone: 307-342-8820
 Fax: 307-333-0261
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation, Substance Use Disorder

261QR0405X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Community Health Worker

172V00000X
 

Counselor

101Y00000X
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for S48WY4, LLC

NPI Number 1770088130
LBN Legal business name S48WY4, LLC
Authorized official LYNN THOMPSON - (PRESIDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/28/2018
Last updated 09/12/2019 - About 7 years ago
Identifiers
WY Medicaid 149784700
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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