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Mental Health & Recovery Services Of Jackson Hole
Substance Use Disorder Rehabilitation Clinic/Center in Jackson, Wyoming
NPI 1578635462

Mental Health & Recovery Services Of Jackson Hole is a Substance Use Disorder Rehabilitation Clinic/Center based in Jackson, WY and is specialized in Rehabilitation, Substance Use Disorder. Mental Health & Recovery Services Of Jackson Hole practices in Jackson, WY. The NPI Number for Mental Health & Recovery Services Of Jackson Hole is 1578635462 and holds a License No. (Wyoming).

The current practice location address for Mental Health & Recovery Services Of Jackson Hole is 640 E Broadway Ave, Jackson, WY and can be reached out via phone at 307-733-2046 and via fax at 307-733-6289.

Location: 640 E Broadway Ave, Jackson, WY, 83001-1868
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1578635462
Provider Name
Mental Health & Recovery Services Of Jackson Hole
Credential
Provider Entity Type
Organization
Address
640 E Broadway Ave, Jackson, WY, 83001-1868
Phone Number
307-733-2046
Fax Number
307-733-6289
Provider Enumeration Date
11/15/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00708001 01 WY BLUSE CROSS BLUE SHIELD
106872504 05 WY
106872503 05 WA
106872500 05 WY
institution
Provider Business Practice Location Address Details
Address
640 E Broadway Ave
City
Jackson
State
Wyoming
Zip
83001
Phone Number
307-733-2046
Fax Number
307-733-6289
person
Provider Business Mailing Address Details
Address
640 E Broadway Ave
City
Jackson
State
Wyoming
Zip
83001
Phone Number
307-733-2046
Fax Number
307-733-6289
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Day Training, Developmentally Disabled Services
Speciality
-
Taxonomy
251C00000X
License No.
()
Definition
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
()
Definition
Definition to come...
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