Region V Boces

NPI #1801159447 in Wilson, Wyoming

Provider Information

NPI Number: 1801159447
Entity Type: Organization
Organization Name: Region V Boces
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Jun 19, 2012
Last Updated: Jun 19, 2012

Practice Location

Address: 3850 NORTH WILDERNESS DRIVE
City: Wilson
State: Wyoming
ZIP Code: 83014-0240
Phone: (307) 733-8210

Authorized Official

Name: MR. MAURICE KEITH MADER, M.S.W./L.C.S.W.
Title: SCHOOL AND CLINICAL SOCIAL WORKER
Phone: (307) 733-8210

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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