Provider Demographics
NPI:1053650523
Name:SHELLEY BRUCE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SHELLEY BRUCE ENTERPRISES, INC.
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:406-249-8438
Mailing Address - Street 1:95 INDIAN TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2613
Mailing Address - Country:US
Mailing Address - Phone:406-755-4030
Mailing Address - Fax:406-755-1070
Practice Address - Street 1:95 INDIAN TRAIL RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2613
Practice Address - Country:US
Practice Address - Phone:406-755-4030
Practice Address - Fax:406-755-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health