MAGIC CITY ENTERPRISES (NPI# 1457744724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457744724 |
| Entity Type | Organization |
| Organization Name | MAGIC CITY ENTERPRISES |
| Practice Address |
1780 Westland Rd Cheyenne WY 82001-3322 |
| Practice Telephone | 3076378869 |
| Practice Fax Number | 3076380467 |
| Mailing Telephone | 3076378869 |
| Mailing Fax Number | 3076384467 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |
| Authorized Official Name | MANDY LILEY (BUSINESS MANAGER) |
| Authorized Official Telephone | 3076378869 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 315P00000X | Intermediate Care Facility, Mentally Retarded | 1194895359 | WY | Nursing & Custodial Care Facilities |
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | 1194895359 | WY | Residential Treatment Facilities |
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1194895359 | WY | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 1194895359 | 05 | |
| WY | MEDICARE PTAN | W21288 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629406269 | Magic City Enterprises | Case Management | 540 Melton St Apt 4, Cheyenne, WY 82009-4753 | 2013-10-16 |
| 1902235054 | Magic City Enterprises | Case Management | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2013-11-08 |
| Street Address |
1780 WESTLAND RD |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82001-3322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194895359 | Magic City Enterprises, Inc | Psychologist | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2006-11-08 |
| 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 | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164894390 | Sharon Schwartz | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1507 Phoenix Ave, Gillette, WY 82716-1936 | 2015-10-27 |
| 1750642526 | Region V Boces | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3850 N. Wilderness Dr., Wilson, WY 83014 | 2012-06-07 |
Please comment or provide details below to improve the information on MAGIC CITY ENTERPRISES.
| 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.