NPI 1043332430
Life Skills Rehabilitation Center, L.L.C.
Practice location
- Address
- 3405 White Mountain Blvd, Rock Springs, WY 82901-4729
- Phone
- (307) 362-6029
Authorised official
- Name
- Gordon Max Mickelson
- Title
- Partner
- Phone
- (307) 389-9169
Registered specialties
Developmentally Disabled Services Day Training Agency
Primary
Registry record
- NPI
- 1043332430
- Entity type
- Organization
- NPI issued
- 4 Apr 2007
- Record last updated
- 22 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.