Provider Demographics
NPI:1235279498
Name:LOVE CARE & DIGNITY, INC.
Entity Type:Organization
Organization Name:LOVE CARE & DIGNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:V
Authorized Official - Last Name:KUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-432-0494
Mailing Address - Street 1:3344 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1734
Mailing Address - Country:US
Mailing Address - Phone:307-432-0494
Mailing Address - Fax:307-632-0898
Practice Address - Street 1:3344 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1734
Practice Address - Country:US
Practice Address - Phone:307-432-0494
Practice Address - Fax:307-632-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY116988201Medicaid
WY116988200Medicaid