Organization · Type 2 NPI

Diversicare of Laramie, LLC

Skilled Nursing Facility · Laramie, WY

NPI number 1114306172 Active

Practice location

503 S 18th St
Laramie, WY 82070-4303

Fax (615) 620-7875

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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NPI record

NPI: 1114306172
Entity type: Organization (Type 2)
Issued: May 23, 2015
Last updated: May 23, 2015
Status: Active
Subpart: Yes of Diversicare Leasing Company Ii, LLC

Other names

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Diversicare of Laramie · doing business as

Authorized official

Kelly J Gill
President & CEO
(615) 771-7575

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114306172

Diversicare of Laramie, LLC's National Provider Identifier is 1114306172, issued on May 23, 2015. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Laramie, WY. The record was last updated on May 23, 2015.