Provider Demographics
NPI:1770040982
Name:BAIRD HUDSON ENTERPRISES, LLC
Entity Type:Organization
Organization Name:BAIRD HUDSON ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:BAIRD
Authorized Official - Last Name:BAIRD HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-746-3228
Mailing Address - Street 1:108 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WY
Mailing Address - Zip Code:82701-2104
Mailing Address - Country:US
Mailing Address - Phone:307-941-1919
Mailing Address - Fax:
Practice Address - Street 1:108 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WY
Practice Address - Zip Code:82701-2104
Practice Address - Country:US
Practice Address - Phone:307-941-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-24
Last Update Date:2019-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY68BA8FA68AMedicaid