MAGIC CITY ENTERPRISES NPI 1457744724

NPI Information

NPI: 1457744724
Provider Name: MAGIC CITY ENTERPRISES
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
1780 WESTLAND RD
CHEYENNE, WY
ZIP 82001
Phone: (307) 637-8869
Get Directions

MAGIC CITY ENTERPRISES is a residential treatment facility, intellectual and/or developmental disabilities in Cheyenne, WY. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. MAGIC CITY ENTERPRISES NPI is 1457744724. The provider is registered as an organization entity type.

The provider's business location address is:

1780 WESTLAND RD
CHEYENNE, WY
ZIP 82001-322
Phone: (307) 637-8869
Fax: (307) 638-0467

The provider's authorized official is Mandy Liley .
The authorized official title is Business Manager and has the following contact phone number (307) 637-8869.

The enumeration date for this NPI number is 3/11/2015 and was last updated on 3/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities	1194895359	WYOMING	No
2	320700000X	Residential Treatment Facility, Physical Disabilities	1194895359	WYOMING	No
3	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	1194895359	WYOMING	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W21288	OTHER	WYOMING	MEDICARE PTAN
2	1194895359	MEDICAID	WYOMING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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