MAGIC CITY ENTERPRISES, INC (NPI# 1194895359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194895359 |
| Entity Type | Organization |
| Organization Name | MAGIC CITY ENTERPRISES, INC |
| Practice Address |
1780 Westland Rd Cheyenne WY 82001-3322 |
| Practice Telephone | 3076378869 |
| Practice Fax Number | 3076380467 |
| Mailing Telephone | 3076378869 |
| Mailing Fax Number | 3076380467 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | MS. MANDY JANE LILEY (VICE PRESIDENT OF BUSINESS SERVICES) |
| Authorized Official Telephone | 3076378869 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
WY | Behavioral Health & Social Service Providers | |
| Y | 251C00000X | Day Training, Developmentally Disabled Services | WY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 100132901 | 05 | |
| WY | 100132912 | 05 | |
| WY | 100132911 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386819308 | Magic City Enterprises, Inc | Day Training, Developmentally Disabled Services | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2008-04-30 |
| Street Address |
1780 WESTLAND RD |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82001-3322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457744724 | Magic City Enterprises | Intermediate Care Facility, Mentally Retarded | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2015-03-11 |
| 1902235054 | Magic City Enterprises | Case Management | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2013-11-08 |
| 1396184065 | Aubrie Lynn Pickens | Case Manager/Care Coordinator | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2013-06-17 |
| 1922343169 | Nancy Kay Krois | Case Manager/Care Coordinator | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2012-11-28 |
| 1427314277 | Allison Drake | Case Manager/Care Coordinator | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2012-04-05 |
| 1508091026 | Anthony Scoville | Case Manager/Care Coordinator | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2009-05-28 |
| 1639304728 | Magic City Enterprises, Inc. | Day Training, Developmentally Disabled Services | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2009-05-19 |
| 1386819308 | Magic City Enterprises, Inc | Day Training, Developmentally Disabled Services | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2008-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194382150 | Brain Advancement Center, LLC | Counselor | 2005 Warren Ave., Cheyenne, WY 82001 | 2019-05-24 |
| 1255897385 | Humble Horizon Home Health LLC | Case Management | 6066 Wilderness Trl, Cheyenne, WY 82001 | 2019-02-13 |
| 1396214722 | Megan Kraushaar | Behavior Technician | 3120 Old Faithful Rd, Cheyenne, WY 82001 | 2018-11-14 |
| 1255815536 | Michelle Mae Mccoy | Social Worker | 2360 E Perishing Blvd, Cheyenne, WY 82001 | 2018-09-21 |
| 1750869616 | Finding Peace Counseling, LLC | Counselor | 1603 Capitol Ave Ste 510b, Cheyenne, WY 82001 | 2018-08-02 |
| 1457855595 | Better Life Counseling LLC | Counselor | 2909 Bent Ave Ste 5, Cheyenne, WY 82001 | 2018-03-22 |
| 1942729066 | Brittany Heinzman | Community Health Worker | 2000 Westland Road Suite C, Cheyenne, WY 82001 | 2017-09-11 |
| 1144768086 | Cheyenne Regional Home Home Care Services | Case Management | 214 E 23rd Street, Cheyenne, WY 82001 | 2017-02-10 |
| 1104360726 | Jennifer Pannebaker | Behavioral Analyst | 813 Randall Ave, Cheyenne, WY 82001 | 2016-12-16 |
| 1053854703 | Raven Coward Long | Social Worker | 821 East Pershing Blvd, Cheyenne, WY 82001 | 2016-11-29 |
| Find all providers in zip 82001 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524628 | Mac Patrik Reynolds | Day Training, Developmentally Disabled Services | 620 W Prosser Rd Lot H, Cheyenne, WY 82007-3054 | 2020-09-28 |
| 1235751389 | B.a.c.a. Case Managment LLC | Day Training, Developmentally Disabled Services | 6500 Longabaugh Way, Cheyenne, WY 82009-9699 | 2020-05-12 |
| 1073009403 | Christopher Aaron Grooms | Day Training, Developmentally Disabled Services | 1745 E 22nd St, Cheyenne, WY 82001-4138 | 2018-07-09 |
| 1689119695 | Kristy Wilmarth | Day Training, Developmentally Disabled Services | 3339 Grove Dr, Cheyenne, WY 82001-1755 | 2016-12-29 |
| 1558804682 | Jahnice Marie Samson | Day Training, Developmentally Disabled Services | 708 E Longhorn Rd, Cheyenne, WY 82009-1102 | 2016-11-21 |
| 1851841852 | Chassity Wiederspahn | Day Training, Developmentally Disabled Services | 1502 Crook Ave, Cheyenne, WY 82001-5322 | 2016-10-13 |
| 1326594433 | Ashley Singleton | Day Training, Developmentally Disabled Services | 1008 Melody Ln, Cheyenne, WY 82007-2753 | 2016-08-29 |
| 1336502905 | Felicia Raimondi | Day Training, Developmentally Disabled Services | 3123 Iron Mountain Rd, Cheyenne, WY 82009-9607 | 2016-03-31 |
| 1477915536 | Stacie Rayl | Day Training, Developmentally Disabled Services | 4602 E 10th St, Cheyenne, WY 82001-6704 | 2016-03-27 |
| 1588020747 | Stacy Strasser | Day Training, Developmentally Disabled Services | 8704 Cowpoke Rd, Cheyenne, WY 82009-1236 | 2016-01-04 |
| Find all providers in CHEYENNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.