Provider Demographics
NPI:1770244337
Name:WYMONT HOMES, INC
Entity Type:Organization
Organization Name:WYMONT HOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-254-4967
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82411-0130
Mailing Address - Country:US
Mailing Address - Phone:307-254-4967
Mailing Address - Fax:
Practice Address - Street 1:200 VINE ST
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MT
Practice Address - Zip Code:59327-7963
Practice Address - Country:US
Practice Address - Phone:406-346-2008
Practice Address - Fax:406-346-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility