Provider Demographics
NPI:1083756787
Name:BLACKFEET OPPORTUNITIES, INC.
Entity Type:Organization
Organization Name:BLACKFEET OPPORTUNITIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOMBERG
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:406-338-5364
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-0247
Mailing Address - Country:US
Mailing Address - Phone:406-338-5364
Mailing Address - Fax:406-338-2942
Practice Address - Street 1:BLACKFEET OPPORTUNITES INC
Practice Address - Street 2:213 N PIEGAN ST
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417
Practice Address - Country:US
Practice Address - Phone:406-338-5364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services