BOYS & GIRLS CLUB OF EVANSTON (NPI# 1073972972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073972972 |
| Entity Type | Organization |
| Organization Name | BOYS & GIRLS CLUB OF EVANSTON |
| Practice Address |
419 4th St Evanston WY 82930-3616 |
| Practice Telephone | 3074442582 |
| Mailing Telephone | 3074442582 |
| Enumeration Date | 2016-02-19 |
| Last Update Date | 2016-02-19 |
| Authorized Official Name | HOLLY SLADE (CEO) |
| Authorized Official Telephone | 3074442582 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | WY | Agencies |
| Street Address |
419 4TH ST |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-3616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316310105 | Emileigh Hillstead | Peer Specialist | 419 4th St, Evanston, WY 82930-3616 | 2015-11-03 |
| 1376903104 | Alicia Burton | Case Manager/Care Coordinator | 419 4th St, Evanston, WY 82930-3616 | 2016-03-07 |
| 1831558741 | Caitlin Holmes | Case Manager/Care Coordinator | 419 4th St, Evanston, WY 82930-3616 | 2016-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780181842 | Center for Independent Futures | Case Management | 1015 Davis St Ste 1, Evanston, IL 60201-5936 | 2018-04-06 |
| 1063945806 | Optimus Services, LLC | Case Management | 205 Washakie Dr, Evanston, WY 82930-4720 | 2017-04-08 |
| 1750730602 | Community Case Management Inc | Case Management | 112 Alecias Way, Evanston, WY 82930-6701 | 2016-06-10 |
| 1457358376 | Tender Heart Home Care Hospice | Case Management | 624 Twin Ridge, Evanston, WY 82931-2130 | 2005-07-07 |
| 1154954675 | Amber Michelle Lowrey | Case Management | 1101 Center St, Evanston, WY 82930-3383 | 2020-02-13 |
| 1023648052 | Compassionate Journey LLC | Case Management | 624 Twin Ridge Ave, Evanston, WY 82930-5108 | 2020-01-17 |
| 1043868516 | Sean Shepherd | Case Management | 1101 Center St, Evanston, WY 82930-3383 | 2019-08-28 |
| 1871063974 | Wraparound Solutions LLC | Case Management | 1101 Center St, Evanston, WY 82930-3383 | 2018-11-30 |
| 1588130454 | Tim Floyd | Case Management | 1425 Highway 150 S, Evanston, WY 82930-5377 | 2018-10-18 |
| 1134626377 | Giuseppe Paucarpura | Case Management | 219 7th St, Evanston, WY 82930-3537 | 2018-04-12 |
| Find all providers in EVANSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.