Healthcare Provider Details

I. General information

NPI: 1487567830
Provider Name (Legal Business Name): JL PERSONAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FORGET ME NOT
CASPER WY
82604-3845
US

IV. Provider business mailing address

161 FORGET ME NOT
CASPER WY
82604-3845
US

V. Phone/Fax

Practice location:
  • Phone: 307-259-3181
  • Fax:
Mailing address:
  • Phone: 307-259-3181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: JOY LEIST
Title or Position: OWNER
Credential:
Phone: 307-259-3181