CANDICE RAE GRONBERG


Address: 4 Roberts Road, Lander, WY 82520-1401
Phone: 3073329122

CANDICE RAE GRONBERG (NPI# 1356632087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356632087
Entity Type Individual
Full Name CANDICE RAE GRONBERG
Practice Address 4 Roberts Road
Lander
WY 82520-1401
Mailing Address Po Box 1401
4 Roberts Road
Lander
WY 82520-1401
Practice Telephone 3073329122
Practice Fax Number 3073329122
Mailing Telephone 3073329122
Mailing Fax Number 3073329122
Enumeration Date 2011-04-28
Last Update Date 2011-04-28
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 385HR2060X Respite Care
Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child
114858300 WY Respite Care Facility

Office Location

Street Address 4 ROBERTS ROAD
City LANDER
State WY
Zip Code 82520-1401

Providers in the same zip code

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1689288201 Wind River Wraparound Community/Behavioral Health 16 Sandhills Rd., Lander, WY 82520 2020-09-01
1346700622 Wind River Family & Community Health Care Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 510 Ethete Rd., Ethete, WY 82520 2019-03-22
1447710843 Wind River Family and Community Health Care Clinic/Center 510 Ethete Road, Ethete, WY 82520 2019-03-21
1780103614 John Thomas Scarince Case Manager/Care Coordinator 748 Main, Lander, WY 82520 2017-09-12
1326560780 Benessere Clinic LLC Specialist 195 Capitol St., Lander, WY 82520 2017-07-07
1881134500 Susan Kreager Nutritionist 643 Blue Sky Hwy 132, Ethete, WY 82520 2017-02-28
1346792298 Elisabeth Krause Clinic/Center 65 N, Granier Ave, Atlantic City, WY 82520 2016-10-26
1649640368 Melinda Kay Cox Day Training, Developmentally Disabled Services 382 Washakie, Lander, WY 82520 2015-10-07
1942602677 Carmen Champlin Registered Nurse 397 S 5th, Lander, WY 82520 2014-09-25
1366867806 Kelly Johnson Social Worker 7324 Highway 789, Lander, WY 82520 2014-02-20
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Taxonomy Information

Taxonomy Code 385HR2060X
Grouping Respite Care Facility
Classification Respite Care
Specialization Respite Care, Mental Retardation and/or Developmental Disabilities, Child

Taxonomy Definition

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1942830823 Toni Rae Vavra-wilder Respite Care 2407 E 16th St, Cheyenne, WY 82001-5307 2020-01-20
1013454438 Shelby Elliott Respite Care 1634 Jim Bridger Ave, Casper, WY 82604-3121 2017-01-23
1225406754 Patricia Masters Respite Care 6678 Bailey Place, Casper, WY 82604 2015-09-15
1669601217 Jy Adekale Global Initiative Respite Care 4913 Ridge Rd, Cheyenne, WY 82009-5309 2009-07-03
1316181167 Danielle Marie Naughton Respite Care 1931 S Washington St, Casper, WY 82601-4855 2009-04-23
1184893026 Hope Unlimited,inc Respite Care 133 Shady Ln, Evanston, WY 82930-4761 2008-02-25
1689866790 Mark Alan Courtney Respite Care 2508 Central Ave, Cody, WY 82414-9797 2007-08-13
1730380106 Heather Louise Haskell Respite Care 261 Shipwheel Rd, Moorcroft, WY 82721 2007-05-31
1538370895 Cheyenne Assisted Living & Support Respite Care 807 Mitchell Ct, Cheyenne, WY 82007-2814 2007-05-25
1750429262 Kathleen L. Otte Respite Care 382 N Lincoln St, Laramie, WY 82070-6100 2007-02-05
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Competitor

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City LANDER
Zip Code 82520

Improve Information

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Dataset Information

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.

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