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Candice Rae Gronberg
Child Intellectual and/or Developmental Disabilities Respite Care in Lander, Wyoming
NPI 1356632087

Candice Rae Gronberg is a Child Intellectual and/or Developmental Disabilities Respite Care based in Lander, WY and is specialized in Respite Care, Intellectual and/or Developmental Disabilities, Child. Candice Rae Gronberg practices in Lander, WY. The NPI Number for Candice Rae Gronberg is 1356632087 and holds a License No. 114858300 (Wyoming).

The current practice location address for Candice Rae Gronberg is 4 Roberts Road, Lander, WY and can be reached out via phone at 307-332-9122 and via fax at 307-332-9122.

Location: 4 Roberts Road, Lander, WY, 82520-1401
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356632087
Provider Name
Candice Rae Gronberg
Credential
Provider Entity Type
Individual
Gender
Female
Address
4 Roberts Road, Lander, WY, 82520-1401
Phone Number
307-332-9122
Fax Number
307-332-9122
Provider Enumeration Date
04/28/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4 Roberts Road
City
Lander
State
Wyoming
Zip
82520-1401
Phone Number
307-332-9122
Fax Number
307-332-9122
person
Provider Business Mailing Address Details
Address
4 Roberts Road
City
Lander
State
Wyoming
Zip
82520-1401
Phone Number
307-332-9122
Fax Number
307-332-9122
person
Provider's Taxonomy Details 1
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Intellectual and/or Developmental Disabilities, Child
Taxonomy
385HR2060X
License No.
114858300 (Wyoming)
Definition
A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
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