| Ark Regional Services, Inc. | |
|
1150 N 3rd St Laramie WY 82072 | |
| (307) 742-6641 | |
| (307) 742-9203 |
| Full Name | Ark Regional Services, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1150 N 3rd St, Laramie, Wyoming |
| Authorized Official Name and Position | Leroy Martin (VP - FINANCE) |
| Authorized Official Contact | 3077426641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ark Regional Services, Inc. 1150 N 3rd St Laramie WY 82072-2514 Ph: (307) 742-6641 | Ark Regional Services, Inc. 1150 N 3rd St Laramie WY 82072 Ph: (307) 742-6641 |
| NPI Number | 1023344942 |
|---|---|
| Provider Enumeration Date | 10/28/2009 |
| Last Update Date | 09/07/2018 |
| Medicare PECOS PAC ID | 4486794518 |
|---|---|
| Medicare Enrollment ID | O20091221000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023344942 | NPI | - | NPPES |
| 100128101 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Mary D Moreno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548359946 PECOS PAC ID: 6901807668 Enrollment ID: I20070123000342 |
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