National Provider Identifier Database

WYOMING LIFE RESOURCE CENTER
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

WYOMING LIFE RESOURCE CENTER
8204 STATE HIGHWAY 789
LANDER, WY82520-2941
Phone: 307-335-6700
Fax: 307-335-6764
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for WYOMING LIFE RESOURCE CENTER

NPI Number 1366501561
Legal business name
LBN
WYOMING LIFE RESOURCE CENTER
Authorized official KEVIN KULOW - (OPERATIONS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 12/06/2006
Last updated 07/17/2025 - About 11 months ago
Sole proprietor1 Not specified
Identifiers
  • WY License #: 100180900
  • WY Medicaid: 100180900

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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