| NPI | 1932260049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY ODOM CEO 307-754-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: WY 07067) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-10-23 |