| Organization Name: | NORTHERN WYOMING MENTAL HEALTH CENTER, INC. |
| NPI Number: | 1013292473 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL E. DEMPLE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1221 W 5th St Sheridan |
| State: | WY US |
| Postal Code: | 828012701 |
| Phone Number: | 3076744405 |
| Fax Number: | 3076735167 |
| NPI Enumeration Date: | 10/18/2011 |
| NPI Last Update Date: | 12/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |