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State Of Wyoming
Intellectual Disabilities Intermediate Care Facility in Lander, Wyoming
NPI 1700949278

State Of Wyoming is a Intellectual Disabilities Intermediate Care Facility based in Lander, WY. State Of Wyoming practices in Lander, WY. The NPI Number for State Of Wyoming is 1700949278 and holds a License No. 100180904 (Wyoming).

The current practice location address for State Of Wyoming is 8204 Highway 789, Lander, WY and can be reached out via phone at 307-335-6700.

Location: 8204 Highway 789, Lander, WY, 82520
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700949278
Provider Name
State Of Wyoming
Credential
Provider Entity Type
Organization
Address
8204 Highway 789, Lander, WY, 82520
Phone Number
307-335-6700
Fax Number
Provider Enumeration Date
12/18/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100180904 05 WY
institution
Provider Business Practice Location Address Details
Address
8204 Highway 789
City
Lander
State
Wyoming
Zip
82520
Phone Number
307-335-6700
Fax Number
person
Provider Business Mailing Address Details
Address
8204 Highway 789
City
Lander
State
Wyoming
Zip
82520
Phone Number
307-335-6700
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
100180904 (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.
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Intellectual Disabilities Intermediate Care Facility
8204 State Highway 789,
LANDER, WY
82520-2941
307-335-6700
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