MOUNTAIN LODGE LLC (NPI# 1437659877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437659877 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN LODGE LLC |
| Practice Address |
1110 Birch St Douglas WY 82633-2761 |
| Practice Telephone | 3073581897 |
| Mailing Telephone | 3073581897 |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |
| Authorized Official Name | R JOSEPH RUDE (PRESIDENT) |
| Authorized Official Telephone | 4066551883 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
1110 BIRCH ST |
| City | DOUGLAS |
| State | WY |
| Zip Code | 82633-2761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710304399 | A Keeler Family Dental, LLC | Dentist | 1010 E Richards Street, Douglas, WY 82633 | 2014-03-21 |
| 1578836805 | Dawn Marie Marchak-cundy | Counselor | 1841 Madora Avenue, Douglas, WY 82633 | 2012-02-16 |
| 1982894739 | Tanisha Crystal Dexter | Pharmacist | 1202 East Richards Street, Douglas, WY 82633 | 2007-07-27 |
| 1669521324 | Stephan Paul Ediss | Chiropractor | 1330 E. Richards, Douglas, WY 82633 | 2007-01-10 |
| 1831280221 | Shauna R Kohler | Nurse Anesthetist, Certified Registered | 111 S 5th Street, Douglas, WY 82633 | 2006-09-28 |
| 1255438651 | County of Converse | Public Health or Welfare | 442 Center, Douglas, WY 82633 | 2006-09-20 |
| 1104834134 | Mark W Townsend | Dentist | 820 So 10th, Douglas, WY 82633 | 2006-08-04 |
| 1548206642 | Douglas Care Center, LLC | Skilled Nursing Facility | 1108 Birch, Douglas, WY 82633 | 2006-06-20 |
| 1023061223 | North Platte Physical Therapy Services Inc | Physical Therapist | Crook Co Memorial Serv Dist, Sundance, WY 82633 | 2006-05-18 |
| 1902447477 | Amanda Kay Dykes | Nurse Practitioner | 111 S 5th St, Douglas, WY 82633 | 2019-10-04 |
| Find all providers in zip 82633 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568985554 | Lesan Assisted Living, L.L.C. | Assisted Living Facility | 2340 E Primrose St, Douglas, AZ 85607-5102 | 2017-07-20 |
| 1740592773 | Southern Senior Living | Assisted Living Facility | 215 Sellers St, Douglas, GA 31533-4609 | 2010-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578035440 | Casper Independent Living, LLC | Assisted Living Facility | 77 Gardenia St, Casper, WY 82604-3803 | 2018-12-17 |
| 1457890659 | Beyond Home Living, LLC | Assisted Living Facility | 153 Doyle Child Circle, Afton, WY 83110 | 2017-02-21 |
| 1730570128 | Elder Care Inc | Assisted Living Facility | 682 N Main St, Buffalo, WY 82834-1736 | 2015-02-07 |
| 1538581137 | Dubois Assisted Living, Inc | Assisted Living Facility | 5643 Us Highway 26, Dubois, WY 82513-1839 | 2014-01-16 |
| 1962679175 | Sheridan Senior Living, LLC | Assisted Living Facility | 1551 Sugarland Dr, Sheridan, WY 82801 | 2008-05-15 |
| 1184811143 | Jackson Hole Senior Living, LLC | Assisted Living Facility | 3000 W Big Trail Dr, Jackson Hole, WY 83001-9138 | 2007-10-03 |
| 1750588851 | Legacy Home Assisted Living | Assisted Living Facility | 2391 Muddy String Co. Road 122, Thayne, WY 83127 | 2007-07-02 |
| 1932327517 | Cody Senior Living, LLC | Assisted Living Facility | 2401 Cougar Ave, Cody, WY 82414-8499 | 2007-04-22 |
| 1346360377 | Aspen Wind Assisted Living Community, LLC | Assisted Living Facility | 4010 N College Dr, Cheyenne, WY 82001-1960 | 2007-03-31 |
| 1467585034 | Park Place Assisted Living LLC | Assisted Living Facility | 1930 E 12th St, Casper, WY 82601-4075 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
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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.