OrganizationActive
Early Intervention Program
NPI 1104152388 · Developmentally Disabled Services Day Training Agency · Fort Washakie, WY
Provider details
- NPI number
- 1104152388
- Entity type
- Organization
- Primary specialty
- Developmentally Disabled Services Day Training AgencyAgencies
- Organization subpart
- No
- Authorized official
- Sue Jezek, Director(307) 332-3516
Specialties & taxonomies
Agencies
Practice location
90 Ethete Road
Fort Washakie, WY 82514
Phone: (307) 332-3516
Fax: (307) 332-9116
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 610
Fort Washakie, WY 82514-0610
Registry dates
- Enumerated
- 2009-10-23
- Last updated
- 2009-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.