Provider Demographics
NPI:1922570365
Name:MARY CLAIRE CARES LLC
Entity Type:Organization
Organization Name:MARY CLAIRE CARES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NHA
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-359-8200
Mailing Address - Street 1:41 SANDY CT
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-8400
Mailing Address - Country:US
Mailing Address - Phone:307-359-8200
Mailing Address - Fax:
Practice Address - Street 1:2009 LARAMIE ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-1533
Practice Address - Country:US
Practice Address - Phone:307-359-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility