Individual
SHAY BALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 S JONES ST LOT 4, POWELL, WY 82435-3103
(307) 219-8509
Mailing address
333 S JONES ST LOT 4, POWELL, WY 82435-3103
(307) 219-8509
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
251J00000X
Nursing Care Agency
Primary
—
WY
261QA0600X
Adult Day Care Clinic/Center
—
WY
261QD1600X
Developmental Disabilities Clinic/Center
—
WY
261QM0850X
Adult Mental Health Clinic/Center
—
WY
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
WY
3104A0625X
Assisted Living Facility (Mental Illness)
—
WY
372600000X
Adult Companion
—
WY
385HR2055X
Child Mental Illness Respite Care
—
WY
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
WY
385HR2065X
Child Physical Disabilities Respite Care
—
WY
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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