NPI 1437659877

Mountain Lodge LLC

Organisation Assisted Living Facility Douglas, WY

Practice location

Address: 1110 Birch St, Douglas, WY 82633-2761
Phone: (307) 358-1897

Authorised official

Name: R Joseph Rude
Title: President
Phone: (406) 655-1883

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

Other Assisted Living Facility providers in Wyoming →

Registry record

NPI: 1437659877
Entity type: Organization
NPI issued: 12 Feb 2018
Record last updated: 12 Feb 2018

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.