Boys & Girls Club of Evanston

NPI #1073972972 in Evanston, Wyoming

Provider Information

NPI Number: 1073972972
Entity Type: Organization
Organization Name: Boys & Girls Club of Evanston
Primary Specialty: Case Management
Enumeration Date: Feb 19, 2016
Last Updated: Feb 19, 2016

Practice Location

Address: 419 4TH ST
City: Evanston
State: Wyoming
ZIP Code: 82930-3616
Phone: (307) 444-2582

Authorized Official

Name: HOLLY SLADE
Title: CEO
Phone: (307) 444-2582

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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