| NPI | 1073002606 |
|---|---|
| Doing Business As | SKLD WYOMING |
| Doing Business As | ILLUMINATE HC WYOMING |
| Entity Type | Organization |
| Authorized Contact | YAIR ZUCKERMAN Manager 773-517-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-08-17 |