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Magic City Enterprises
Physical Disabilities Residential Treatment Facility in Cheyenne, Wyoming
NPI 1457744724

Magic City Enterprises is a Physical Disabilities Residential Treatment Facility based in Cheyenne, WY. Magic City Enterprises practices in Cheyenne, WY. The NPI Number for Magic City Enterprises is 1457744724 and holds a License No. 1194895359 (Wyoming).

The current practice location address for Magic City Enterprises is 1780 Westland Rd, Cheyenne, WY and can be reached out via phone at 307-637-8869 and via fax at 307-638-0467.

Location: 1780 Westland Rd, Cheyenne, WY, 82001-3322
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457744724
Provider Name
Magic City Enterprises
Credential
Provider Entity Type
Organization
Address
1780 Westland Rd, Cheyenne, WY, 82001-3322
Phone Number
307-637-8869
Fax Number
307-638-0467
Provider Enumeration Date
03/11/2015
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1194895359 05 WY
W21288 01 WY MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1780 Westland Rd
City
Cheyenne
State
Wyoming
Zip
82001-3322
Phone Number
307-637-8869
Fax Number
307-638-0467
person
Provider Business Mailing Address Details
Address
1780 Westland Rd
City
Cheyenne
State
Wyoming
Zip
82001-3322
Phone Number
307-637-8869
Fax Number
307-638-0467
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
1194895359 (Wyoming)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
1194895359 (Wyoming)
Definition
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.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
1194895359 (Wyoming)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
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