| Organization Name: | WIND RIVER HEALTH SYSTEMS, INC. |
| NPI Number: | 1932422375 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNA KAREN ANDERSEN (BUSINESS DEVELOPMENT COORDINATOR) |
| Mailing Address: | 5647 Us Hwy 26 Dubois Medical Clinic Dubois |
| State: | WY US |
| Postal Code: | 825133809 |
| Phone Number: | 3074552516 |
| Fax Number: | 3074552526 |
| NPI Enumeration Date: | 03/11/2010 |
| NPI Last Update Date: | 03/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |