| NPI | 1467162081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAY NICOLE BALES Owner 307-219-8509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2022-12-05 |