Provider Demographics
NPI:1396433918
Name:307 CASE MANAGEMENT SERVICES
Entity type:Organization
Organization Name:307 CASE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-850-5119
Mailing Address - Street 1:715 E ROOSEVELT AVE # 3R
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-3611
Mailing Address - Country:US
Mailing Address - Phone:307-850-5119
Mailing Address - Fax:
Practice Address - Street 1:715 E ROOSEVELT AVE # 3R
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3611
Practice Address - Country:US
Practice Address - Phone:307-850-5119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services