| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Holli Telford Lundahl | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | Provider Number: N/A | [sources] | |||
| First name | HOLLI · Holli Telford | [sources] | |||
| Last name | Lundahl | [sources] | |||
| Middle name | TELFORD | [sources] | |||
| Sector | Waiver | [sources] | |||
| Position | PERSONAL CARE PROVID (INDIVIDUAL (UNAFFILI) | [sources] | |||
| Address | Fort Worth, TX · P O BOX 27137, #05151-112, FORT WORTH, TX 76127 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in Wyoming's Medicaid program.
United States · WDH
People and companies excluded from Federally funded health care programs
United States · OIG
us-fed-excl-holli-telford-lundahl-76127-fort-worth · us-medwy-7b3ca9431e02f7a204ae68382ce3c90d89d0705dFor experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Department of Health and Human Services Office of Inspector General | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| Fort Worth, TX | United States | |
| United States | Wyoming Department of Health | - | - |