Big Horn Basin Association Adolescent Programs

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

1708G Issued in WY

Legal business name

BIG HORN BASIN ASSOCIATION ADOLESCENT PROGRAMS

Practice address

967 Hwy 20 South
Basin, WY 82410

Phone

(307) 568-2222

Fax

(307) 568-2982

NPI assigned

Sep 3, 2013

Last updated

Sep 3, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brock Greek, LCSW

Title

Director

Phone

(307) 568-2222

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1043644545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "city": "BASIN",
            "state": "WY",
            "postal_code": "824100858",
            "telephone_number": "307-568-2222",
            "fax_number": "307-568-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 HWY 20 SOUTH",
            "city": "BASIN",
            "state": "WY",
            "postal_code": "82410",
            "telephone_number": "307-568-2222",
            "fax_number": "307-568-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG HORN BASIN ASSOCIATION ADOLESCENT PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "GREEK",
        "authorized_official_first_name": "BROCK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "307-568-2222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "WY",
            "license": "1708G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kristi L. Bonnel-Phillips, PA-C
• Abby Bowers, CMHW
• Staci Briscoe
• Ronald Lee Burinsky, D.O.

• Foster Care Agency in Basin, WY
• Providers in Basin, WY by specialty
• Foster Care Agency in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.