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24 Country Club Lane Pinedale WY 82941-0856 | |
| (307) 367-2111 | |
| (307) 367-2166 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 24 Country Club Lane, Pinedale, Wyoming |
| Authorized Official Name and Position | Kipp L Dana (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3078859883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 856 Pinedale WY 82941-0856 Ph: (307) 367-2111 | 24 Country Club Lane Pinedale WY 82941-0856 Ph: (307) 367-2111 |
| NPI Number | 1508058173 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 06/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508058173 | NPI | - | NPPES |
| 117826100 | Medicaid | WY | |
| 117847400 | Medicaid | WY |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Country Club Lane, Pinedale, WY 82941 Phone: 307-367-2111 Fax: 307-367-2166 | |