Provider Demographics
NPI:1730570128
Name:ELDER CARE INC
Entity type:Organization
Organization Name:ELDER CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-684-7418
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-0370
Mailing Address - Country:US
Mailing Address - Phone:307-684-7418
Mailing Address - Fax:307-684-2515
Practice Address - Street 1:682 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834-1736
Practice Address - Country:US
Practice Address - Phone:307-684-7418
Practice Address - Fax:307-684-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY0713165310400000X
WY0814236310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility