NPIMap

Organization Active NPI

White Buffalo Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arapahoe, WY
National Provider Identifier
1902213093
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
WHITE BUFFALO RECOVERY CENTER
Practice address
#22 Great Plains Rd
Arapahoe, WY 82510
Phone
(307) 856-0470
Fax
(307) 857-4383
NPI assigned
Jul 21, 2014
Last updated
Jul 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Authorized official

Name
Sunny Goggles
Title
Director
Phone
(307) 856-0470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

#22 Great Plains Rd
Arapahoe, WY 82510

Mailing address

PO Box 190
St Stephens, WY 82524-0190

National Provider Directory

National Provider Directory
Tax ID family
Northern Arapaho Tribal Health Programs3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1902213093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "ST STEPHENS",
            "state": "WY",
            "postal_code": "825240190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#22 GREAT PLAINS RD",
            "city": "ARAPAHOE",
            "state": "WY",
            "postal_code": "82510",
            "telephone_number": "307-856-0470",
            "fax_number": "307-857-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE BUFFALO RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "GOGGLES",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "307-856-0470"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arapahoe, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.