| NPI | 1851481634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA A REED Administrator 307-332-6902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WY 07-153) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-07-22 |