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General NPI Number Information
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NPI Number | 1467366385
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Entity Type | Organization
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Legal Business Name | PORRAS RESORT LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 307 LONGHORN CT
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City | GILLETTE
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State | WY
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Zip | 82718-7875
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Country | US
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Telephone | 307-689-6402
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Fax |
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Provider Business Mailing Address
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Address Line | 307 LONGHORN CT
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City | GILLETTE
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State | WY
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Zip | 82718-7875
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Country | US
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Telephone | 307-689-6402
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | TERRI PORRAS
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Credential |
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Telephone | 307-689-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NULL
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