| NPI | 1609580596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAY BALES Owner 307-219-8509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251J00000X Nursing Care | |
| 261QA0600X Clinic/Center Adult Day Care | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 314000000X Skilled Nursing Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| 385HR2050X Respite Care Respite Care Camp | |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-01-06 |