# MOUNTAIN REGIONAL SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013337880
- **Authorized official:** RANDY IWEN (CONTROLLER)
- **Authorized official phone:** (307) 789-3710

## Contact information

- **Practice address:** 50 ALLEGIANCE CIR, EVANSTON, WY 82930-3804
- **Practice address phone:** (307) 778-9371
- **Practice address fax:** (307) 789-0823
- **Mailing address:** PO BOX 6005, EVANSTON, WY 82931-6005
- **Mailing address phone:** (307) 789-3710
- **Mailing address fax:** (307) 789-0823

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 32521 | WY | Yes |

## Other

- **Enumeration date:** 04/21/2014
- **Last updated:** 04/21/2014