Provider Demographics
NPI:1043436983
Name:COMMUNITY ACTION OF LARAMIE COUNTY, INC
Entity type:Organization
Organization Name:COMMUNITY ACTION OF LARAMIE COUNTY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-274-3010
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-0106
Mailing Address - Country:US
Mailing Address - Phone:307-635-9291
Mailing Address - Fax:307-632-6131
Practice Address - Street 1:1700 WESTLAND RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3322
Practice Address - Country:US
Practice Address - Phone:307-635-9291
Practice Address - Fax:307-632-6131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY20234.0234261QF0400X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care