| NPI | 1194981720 |
|---|---|
| Doing Business As | WYOMING HOME |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W ALLEN Vice President, Finance & Facilitie 937-436-6885 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2020-12-23 |