Provider Demographics
NPI:1922198936
Name:WYOMING PIONEER HOME
Entity Type:Organization
Organization Name:WYOMING PIONEER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-864-3151
Mailing Address - Street 1:141 PIONEER HOME DR
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-2451
Mailing Address - Country:US
Mailing Address - Phone:307-864-3151
Mailing Address - Fax:307-864-2934
Practice Address - Street 1:141 PIONEER HOME DR
Practice Address - Street 2:
Practice Address - City:THERMOPOLIS
Practice Address - State:WY
Practice Address - Zip Code:82443-2451
Practice Address - Country:US
Practice Address - Phone:307-864-3151
Practice Address - Fax:307-864-2934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY07-201310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility