Organization
HEART MOUNTAIN HOME CARE LLC
Active
Organization
HEART MOUNTAIN HOME CARE LLC
Active
Other names
Heart Moutain HomeCare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHAY BALES CNA (OWNER)
(307) 219-8509
Entity
Organization
Contact information
Practice address
333 S JONES #4, POWELL, WY 82435-3103
(307) 219-8509
Mailing address
351 S GILBERT ST, POWELL, WY 82435-3016
(307) 219-8509
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
314000000X
Skilled Nursing Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92151784
—
WY
Enumeration date
01/06/2023
Last updated
01/06/2023
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