Organization
CASPER HEALTHCARE LLC
Active
Parent organization
MISSION HEALTHCARE LLC
Other names
Shepherd of the Valley Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSION HEALTHCARE LLC
Authorized official
MR. THOMAS E BOERBOOM (CHIEF OPERATING OFFICER)
(952) 873-7907
Entity
Organization
Contact information
Practice address
60 MAGNOLIA, CASPER, WY 82604-3801
(307) 234-9381
(307) 234-6205
Mailing address
60 MAGNOLIA, CASPER, WY 82604-3801
(307) 234-9381
(307) 234-6205
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10216
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106292100
—
WY
Enumeration date
07/09/2006
Last updated
05/08/2012
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