Organization
LIFE SKILLS OF WYOMING, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON MAX MICKELSON III (OWNER)
(307) 875-3535
Entity
Organization
Contact information
Practice address
350 HILLCREST WAY, GREEN RIVER, WY 82935-4007
(307) 875-3535
(307) 875-3031
Mailing address
350 HILLCREST WAY, GREEN RIVER, WY 82935-4007
(307) 875-3535
(307) 875-3031
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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