2400 Home, LLC
Organization Active NPI In Home Supportive Care Agency · Cheyenne, WY
NPI 1013670264 · NPPES record last updated Oct 14, 2021
Key facts
- NPI
- 1013670264
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Legal business name
- 2400 HOME, LLC
- Practice address
- 2400 Dunn Ave Ste B
Cheyenne, WY 82001-3216 - Phone
- (307) 778-8236
- Fax
- (307) 632-4338
- NPI assigned
- Oct 14, 2021
- Organization subpart
- No
Authorized official
- Name
- Mr. Rande Charles Pouppirt
- Title
- Partner
- Phone
- (307) 778-8236
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- 2400 Home LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
2400 Dunn Ave Ste B
Cheyenne, WY 82001-3216
Mailing address
2400 Dunn Ave Ste B
Cheyenne, WY 82001-3216
Phone (307) 778-8236
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.