Provider Demographics
NPI:1366562134
Name:DIVERSIFIED SERVICES INC.
Entity type:Organization
Organization Name:DIVERSIFIED SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-532-5911
Mailing Address - Street 1:PO BOX 1078
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-1078
Mailing Address - Country:US
Mailing Address - Phone:307-532-5911
Mailing Address - Fax:307-532-7328
Practice Address - Street 1:1138 W C ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-3371
Practice Address - Country:US
Practice Address - Phone:307-532-5911
Practice Address - Fax:307-532-7328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services