Organization Name: | WILLIAM H AND CARRIE GOTTSCHE FOUNDATION |
NPI Number: | 1558319392 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHERYL A SHERO (EXECUTIVE DIRECTOR) |
Mailing Address: | 148 E Arapahoe St Thermopolis |
State: | WY US |
Postal Code: | 824432402 |
Phone Number: | 3078642146 |
Fax Number: | 3078642857 |
NPI Enumeration Date: | 05/04/2006 |
NPI Last Update Date: | 01/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0401X |
License Number: | 06-045 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Taxonomy Definition: |