S48Wy4, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

S48WY4, LLC

Doing business as

Wyoming Recovery of Rawlins

Practice address

606 23Rd St
Rawlins, WY 82301-5127

Phone

(307) 324-8820

NPI assigned

Jan 27, 2021

Last updated

Jan 27, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

WYOMING RECOVERYAs reported in NPPES

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

Authorized official

Name

Amanda Constantino

Title

Human Resources

Phone

(307) 265-3791

Specialties & licenses 3

Addresses

Other names 1

• Wyoming Recovery of Rawlins Doing business as

Tax ID family

S48Wy1 LLC3 organizations share this tax ID, including this one

Part of

S48Wy1 LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• S48Wy4, LLC

  dba Wyoming Recovery Rawlins

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Rawlins, WY
  • NPI 1427648534
  NPD tax ID
• Wyoming Recovery Rawlins

  dba Wyoming Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Rawlins, WY
  • NPI 1528657590
  NPD tax ID

Locations

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1477144160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 S WILSON ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012941",
            "telephone_number": "307-265-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 23RD ST",
            "city": "RAWLINS",
            "state": "WY",
            "postal_code": "823015127",
            "telephone_number": "307-324-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S48WY4, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WYOMING RECOVERY",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "CONSTANTINO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "307-265-3791"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyoming Recovery of Rawlins",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Rodriguez
• Barbara Romero, BA, MED
• Joseph Rosacker, PHARMD
• Abbey L. Ross
• S48Wy4, LLC (Wyoming Recovery Rawlins)
• S48Wy4, LLC (Crossroads Counseling Solutions)
• Johnniejean Sanders
• Keira Lynn Sanders
• Kathryn C. Sapp, LPC
• Corinne R. Schisel

• Substance Use Disorder Rehabilitation Clinic/Center in Rawlins, WY
• Providers in Rawlins, WY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.