| Youth Crisis Center, Inc | |
|
1656 E 12th St Casper WY 82601-4004 | |
| (307) 577-5718 | |
| (307) 577-5716 |
| Full Name | Youth Crisis Center, Inc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1656 E 12th St, Casper, Wyoming |
| Authorized Official Name and Position | David Hulshizer (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3075775718 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Crisis Center, Inc 1656 E 12th St Casper WY 82601-4004 Ph: (307) 577-5718 | Youth Crisis Center, Inc 1656 E 12th St Casper WY 82601-4004 Ph: (307) 577-5718 |
| NPI Number | 1497158182 |
|---|---|
| Provider Enumeration Date | 10/08/2014 |
| Last Update Date | 11/02/2023 |
| Certification Date | 11/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497158182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC-1164 (Wyoming) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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