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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