Provider Demographics
NPI:1902071582
Name:RAWLINS FAMILY MENTAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:RAWLINS FAMILY MENTAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:307-324-5899
Mailing Address - Street 1:501 W BUFFALO ST
Mailing Address - Street 2:P.O. BOX 911
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-5622
Mailing Address - Country:US
Mailing Address - Phone:307-324-5899
Mailing Address - Fax:307-324-2695
Practice Address - Street 1:501 W BUFFALO ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5622
Practice Address - Country:US
Practice Address - Phone:307-324-5899
Practice Address - Fax:307-324-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-230A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty