Provider Demographics
NPI:1225557432
Name:COUNTY OF GLACIER
Entity Type:Organization
Organization Name:COUNTY OF GLACIER
Other - Org Name:GLACIER COUNTY INTEGRATED MOBILE HEALTH SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-873-2727
Mailing Address - Street 1:1102 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUT BANK
Mailing Address - State:MT
Mailing Address - Zip Code:59427-3126
Mailing Address - Country:US
Mailing Address - Phone:406-873-9150
Mailing Address - Fax:406-873-9072
Practice Address - Street 1:1102 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUT BANK
Practice Address - State:MT
Practice Address - Zip Code:59427-3126
Practice Address - Country:US
Practice Address - Phone:406-873-9150
Practice Address - Fax:406-873-9072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF GLACIER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13560251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health