# STATE OF WYOMING

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wyoming Retirement Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659328821
- **Authorized official:** MARLA FAY TAYLOR-THOMAS LNHA (ADMINISTRATOR)
- **Authorized official phone:** (307) 568-2431

## Contact information

- **Practice address:** 890 HIGHWAY 20 S, BASIN, WY 82410-9587
- **Practice address phone:** (307) 568-2431
- **Practice address fax:** (307) 568-3887
- **Mailing address:** 890 HIGHWAY 20 S, BASIN, WY 82410-9587
- **Mailing address phone:** (307) 568-2431
- **Mailing address fax:** (307) 568-3887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 06-107 | WY | Yes |

## Other

- **Enumeration date:** 05/31/2006
- **Last updated:** 03/10/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100176100 | — | WY |