Life Skills Rehabilitation Center, L.L.C.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

LIFE SKILLS REHABILITATION CENTER, L.L.C.

Practice address

3405 White Mountain Blvd
Rock Springs, WY 82901-4729

Phone

(307) 362-6029

NPI assigned

Apr 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gordon Max Mickelson IIINPI 1356678270

Title

Partner

Phone

(307) 389-9169

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gordon Max Mickelson III

  • Case Manager/Care Coordinator
  • Rock Springs, WY
  • NPI 1356678270
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043332430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 WHITE MOUNTAIN BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014729",
            "telephone_number": "307-362-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 WHITE MOUNTAIN BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014729",
            "telephone_number": "307-362-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SKILLS REHABILITATION CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MICKELSON",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "307-389-9169",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cinda Sue Levitt
• Mandi E Lew, CNM
• Emily Leyh, PHARMD
• Linsey Li
• Life Skills for Wyoming, L.L.C.
• Lincare Inc.
• Ross Little
• David A Liu, MD, DDS
• Jessie Lockwood Willoughby
• Kayleen A Logan, MS, APRN, BC

• Developmentally Disabled Services Day Training Agency in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Developmentally Disabled Services Day Training Agency in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.