NPIMap

Organization Active NPI

Wyoming Life Resource Center

  • Intellectual Disabilities Intermediate Care Facility
  • Lander, WY
National Provider Identifier
1366501561
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
100180900 Issued in WY
Legal business name
WYOMING LIFE RESOURCE CENTER
Practice address
8204 State Highway 789
Lander, WY 82520-2941
Phone
(307) 335-6700
Fax
(307) 335-6764
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Authorized official

Name
Kevin Kulow
Title
Operations Manager
Phone
(307) 335-6762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 100180900 WY Primary

Addresses

Primary practice location

8204 State Highway 789
Lander, WY 82520-2941

Mailing address

8204 State Highway 789
Lander, WY 82520-2941
Phone (307) 335-6700

Other identifiers 1

IdentifierTypeStateIssuer
100180900MedicaidWY

National Provider Directory

National Provider Directory
Tax ID family
Division of Health Care11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752710400000",
    "number": "1366501561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8204 STATE HIGHWAY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202941",
            "telephone_number": "307-335-6700",
            "fax_number": "307-335-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 STATE HIGHWAY 789",
            "city": "LANDER",
            "state": "WY",
            "postal_code": "825202941",
            "telephone_number": "307-335-6700",
            "fax_number": "307-335-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING LIFE RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A",
        "authorized_official_last_name": "KULOW",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "307-335-6762"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "WY",
            "license": "100180900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100180900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lander, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.