Jackson Hole Community Counseling Center

LBN: Mental Health & Recovery Services Of Jackson Hole
Jackson Hole Community Counseling Center is an health care organization with primary practice located at 640 E Broadway Ave , Jackson WY 83001. The organization recently has 3 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Mental Health & Recovery Services Of Jackson Hole can be contacted via phone (307) 733-2046, or through Ashley, Deidre via phone (307) 733-2046.

Contact Information

Primary practice address
640 E Broadway Ave Jackson WY 83001
Phone: (307) 733-2046
Fax: (307) 733-6289
Website:
Map and Directions
Authorized official contact:
Name: Ashley, Deidre
Phone: (307) 733-2046

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1578635462
LBN Legal business name Mental Health & Recovery Services Of Jackson Hole
DBA Doing business as Jackson Hole Community Counseling Center
Authorized official Ashley, Deidre
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2006
Last updated Jul 19th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578635462 NPPES
Wyoming Other 00708001 BLUSE CROSS BLUE SHIELD
Wyoming MEDICAID 106872504 BLUSE CROSS BLUE SHIELD
Wyoming MEDICAID 106872503 BLUSE CROSS BLUE SHIELD
Wyoming MEDICAID 106872500 BLUSE CROSS BLUE SHIELD

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