Provider Demographics
NPI:1437271632
Name:WYOMING INSTITUTE FOR BETTER LIVING INC
Entity type:Organization
Organization Name:WYOMING INSTITUTE FOR BETTER LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:MONSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:307-473-8010
Mailing Address - Street 1:123 W 1ST ST STE 760
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2485
Mailing Address - Country:US
Mailing Address - Phone:307-473-8010
Mailing Address - Fax:307-472-5428
Practice Address - Street 1:123 W 1ST ST STE 760
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2485
Practice Address - Country:US
Practice Address - Phone:307-473-8010
Practice Address - Fax:307-472-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW2671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY311090OtherBLUE CROSS BLUE SHIELD