Healthcare Provider Details

I. General information

NPI: 1124922687
Provider Name (Legal Business Name): GUARDIAN'S WATCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 PILOT BUTTE AVE STE 1
ROCK SPRINGS WY
82901-5385
US

IV. Provider business mailing address

3824 HARRIER DR
ROCK SPRINGS WY
82901-6275
US

V. Phone/Fax

Practice location:
  • Phone: 307-371-7738
  • Fax:
Mailing address:
  • Phone: 307-371-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: FELISHA FLETCHER
Title or Position: CO-OWNER
Credential:
Phone: 307-371-7738