Whalio Doctors

NPI 1457744724

Magic City Enterprises

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Cheyenne, WY

Practice location

Address
1780 Westland Rd, Cheyenne, WY 82001-3322
Phone
(307) 637-8869
Fax
(307) 638-0467

Authorised official

Name
Mandy Liley
Title
Business Manager
Phone
(307) 637-8869

Registered specialties (3)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X Licence 1194895359 (WY)
Intellectual Disabilities Intermediate Care Facility
Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 1194895359 (WY)
Physical Disabilities Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320700000X Licence 1194895359 (WY)

Registry record

NPI
1457744724
Entity type
Organization
NPI issued
11 Mar 2015
Record last updated
11 Mar 2015

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.