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Organization
EMPRES AT CHEYENNE, LLC
Active
Organization
EMPRES AT CHEYENNE, LLC
Active
Parent organization
EMPRES WYOMING HEALTHCARE, LLC
Other names
Granite Rehabilitation and Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES WYOMING HEALTHCARE, LLC
Authorized official
BRENT WEIL (CEO AND MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
3128 BOXELDER DR, CHEYENNE, WY 82001-5808
(307) 634-7901
(307) 634-7910
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141200100
—
WY
Enumeration date
07/23/2015
Last updated
01/30/2017
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