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Organization

MOUNTAIN REGIONAL SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANDY IWEN (CONTROLLER)
(307) 789-3710
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
32521
WY

Other

Enumeration date
04/21/2014
Last updated
04/21/2014
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