| Meadows Outpatient Center Wyoming Llc | |
|
1712 Pioneer Ave Cheyenne WY 82001-4406 | |
| (928) 684-4083 | |
| Not Available |
| Full Name | Meadows Outpatient Center Wyoming Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1712 Pioneer Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Tracy Livingston (VP OF REVENUE CYCLE) |
| Authorized Official Contact | 6022563020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Meadows Outpatient Center Wyoming Llc 19820 N 7th St Ste 205 Phoenix AZ 85024-1694 Ph: (602) 256-3020 | Meadows Outpatient Center Wyoming Llc 1712 Pioneer Ave Cheyenne WY 82001-4406 Ph: (928) 684-4083 |
| NPI Number | 1699423616 |
|---|---|
| Provider Enumeration Date | 03/17/2022 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699423616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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