National Provider Identifier Database

STATE OF WYOMING
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

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

* Indicates primary specialty

NPI Profile & details for STATE OF WYOMING

NPI Number 1700949278
Legal business name
LBN
STATE OF WYOMING
Authorized official RACHEL JONES - (ACCOUNTING MANAGER)
Entity Organization
Organization subpart Yes
Enumeration date 12/18/2006
Last updated 09/28/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • WY License #: 100180904
  • WY Medicaid: 100180904

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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