Provider Demographics
NPI:1124205315
Name:HUESTIS & HUESTIS, LLC
Entity Type:Organization
Organization Name:HUESTIS & HUESTIS, LLC
Other - Org Name:THE GOLDSTONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUESTIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-452-1239
Mailing Address - Street 1:5200 9TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5712
Mailing Address - Country:US
Mailing Address - Phone:406-452-1239
Mailing Address - Fax:
Practice Address - Street 1:5200 9TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5712
Practice Address - Country:US
Practice Address - Phone:406-452-1239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0630785Medicaid