CHOICES , ALCOHOL, DRUG & BEHAVIORAL HELP CENTER INC. (NPI# 1336583608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336583608 |
| Entity Type | Organization |
| Organization Name | CHOICES , ALCOHOL, DRUG & BEHAVIORAL HELP CENTER INC. |
| Practice Address |
77 County Road 109 Evanston WY 82930-9797 |
| Practice Telephone | 3077831088 |
| Practice Fax Number | 3077831028 |
| Mailing Telephone | 3077831088 |
| Mailing Fax Number | 3077831028 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2013-04-30 |
| Authorized Official Name | MS. MARY HANSEN BOAL (CO-DIRECTOR) |
| Authorized Official Telephone | 3077831088 |
| Authorized Official Credential | BSW NCACII LAT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | LAT-199 | WY | Residential Treatment Facilities |
| Street Address |
77 COUNTY ROAD 109 |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-9797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023285962 | Thad's House, LLC | Substance Abuse Rehabilitation Facility | 636 E A St, Casper, WY 82601-2004 | 2008-05-09 |
| 1891994950 | S48wy1, LLC | Substance Abuse Rehabilitation Facility | 231 S. Wilson, Casper, WY 82601 | 2007-07-17 |
| 1205369576 | Icbm Inc | Substance Abuse Rehabilitation Facility | 1501 Red Tail Dr, Rock Springs, WY 82901-5879 | 2017-04-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.