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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
320600000X | |||
Intermediate Care Facility, Mentally Retarded |
315P00000X | |||
Residential Treatment Facility, Physical Disabilities |
320700000X |
| NPI # | 1457744724 |
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| LBN Legal business name | MAGIC CITY ENTERPRISES | ||||||||||||
| Authorized official | MANDY LILEY - (BUSINESS MANAGER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 03/11/2015 | ||||||||||||
| Last updated | 03/11/2015 - About 11 years ago | ||||||||||||
| Identifiers |
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MAGIC CITY ENTERPRISES
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| THE OTERO CORPORATION 1204 WEST ASH STREET WINDSOR, CO |
| STAR VALLEY SENIOR CENTER INC 520 WASHINGTON AFTON, WY |
| ELISABETH HEUSINGFELD 389 ADAMS ST AFTON, WY |
| JONAH J GREEN, MD 110 HOSPITAL LN AFTON, WY |
MAGIC CITY ENTERPRISES