# PLATTE COUNTY MEMORIAL NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BANNER HEALTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003951518
- **Legal business name:** BANNER HEALTH
- **Authorized official:** DENNIS LARAWAY (CFO)
- **Authorized official phone:** (602) 747-4000

## Contact information

- **Practice address:** 201 14TH ST, WHEATLAND, WY 82201-3201
- **Practice address phone:** (307) 322-3636
- **Mailing address:** 2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 07-070 | WY | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 12/30/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 106545901 | — | WY |