Healthcare Provider Details

I. General information

NPI: 1578493920
Provider Name (Legal Business Name): PRAIRIE HEART CARE CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6958 WILD BILL CT
CHEYENNE WY
82001-8557
US

IV. Provider business mailing address

6958 WILD BILL CT
CHEYENNE WY
82001-8557
US

V. Phone/Fax

Practice location:
  • Phone: 307-287-3423
  • Fax:
Mailing address:
  • Phone: 307-287-3423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: DAKOTA A FOSTER
Title or Position: COOWNER
Credential: RN
Phone: 307-287-3423