Organization Name: | LSREF GOLDEN OPS 14 (WY) LLC |
NPI Number: | 1033441324 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOM WENTZ (EXEC VP/COO) |
Mailing Address: | 1072 N 22nd St Laramie |
State: | WY US |
Postal Code: | 820725303 |
Phone Number: | 3077555811 |
Fax Number: | 3077210478 |
NPI Enumeration Date: | 02/11/2010 |
NPI Last Update Date: | 02/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 10226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |