- Enrollment id
- O20251111002326
- Enrollment state
- WY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1285523639
- Multiple npi flag
- N
- Ccn
- 535040
- Associate id
- 1456269869
- Organization name
- NORTH BIG HORN HOSPITAL DISTRICT
- Doing business as name
- SUMMIT RIDGE SKILLED NURSING & REHABILITATION
- Organization type structure
- OTHER
- Organization other type text
- HOSPITAL DISTRICT
- Proprietary nonprofit
- N
- Nursing home provider name
- SUMMIT RIDGE SKILLED NURSING & REHABILITATION
- Affiliation entity name
- ROCKY MOUNTAIN CARE
- Affiliation entity id
- 455
- Address line 1
- 1108 BIRCH ST
- City
- DOUGLAS
- State
- WY
- Zip code
- 826332761