CHEYENNE VA DOMICILIARY (3385) INSTITUTION (4)

Name	Value
NAME	CHEYENNE VA DOMICILIARY
STATE	WYOMING
STREET ADDR. 1	2360 E. PERSHING BLVD
CITY	CHEYENNE
ZIP	82001-5356
OFFICIAL VA NAME	CHEYENNE VA DOMICILIARY
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 19 PARENT FACILITY PARENT OF ASSOCIATION: CHEYENNE VA MEDICAL
BILLING FACILITY NAME	CHEYENNE VA CARE SITE
EFFECTIVE DATE/TIME	2016-02-01 00:00:00 STATUS: ACTIVE NPI: 1013448273
TAXONOMY CODE	Residential Treatment Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	MOUNTAIN
STATION NUMBER	442BU