Basic Information
| Provider Information | |||||||||
| NPI: | 1972503506 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WYOMING BEHAVIORAL INSTITUTE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2521 E 15TH ST | ||||||||
| Address2: | |||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826094126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072377444 | ||||||||
| FaxNumber: | 3074737144 | ||||||||
| Practice Location | |||||||||
| Address1: | 2521 E 15TH ST | ||||||||
| Address2: | |||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826094126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072377444 | ||||||||
| FaxNumber: | 3074737144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SEXTON | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3072377444 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | 05-191 | WY | Y | Hospitals | Psychiatric Hospital |
No ID Information.