National Provider Identifier Database

MAGIC CITY ENTERPRISES
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.


Contact Information

MAGIC CITY ENTERPRISES
1780 WESTLAND RD
CHEYENNE, WY82001-3322
Phone: 307-637-8869
Fax: 307-638-0467
Website:
Specialty Taxonomy Code
* Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X
Intermediate Care Facility, Mentally Retarded 315P00000X
Residential Treatment Facility, Physical Disabilities 320700000X

* Indicates primary specialty

NPI Profile & details for MAGIC CITY ENTERPRISES

NPI Number 1457744724
Legal business name
LBN
MAGIC CITY ENTERPRISES
Authorized official MANDY LILEY - (BUSINESS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 03/11/2015
Last updated 03/11/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • WY License #: 1194895359
  • WY Medicaid: 1194895359
  • WY Other: W21288 MEDICARE PTAN

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.

Reviews for MAGIC CITY ENTERPRISES

There are currently no reviews for MAGIC CITY ENTERPRISES


NPIdb - Home
v2.201