Provider Demographics
NPI:1275616856
Name:BUTTE-SILVER BOW CONSOLIDATED GOVERNMENTS
Entity Type:Organization
Organization Name:BUTTE-SILVER BOW CONSOLIDATED GOVERNMENTS
Other - Org Name:CITY COUNTY HOME HEALTH SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOCKING
Authorized Official - Suffix:
Authorized Official - Credentials:RN CK
Authorized Official - Phone:406-497-5000
Mailing Address - Street 1:25 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701
Mailing Address - Country:US
Mailing Address - Phone:406-497-5000
Mailing Address - Fax:406-782-8150
Practice Address - Street 1:25 W FRONT ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2801
Practice Address - Country:US
Practice Address - Phone:406-497-5000
Practice Address - Fax:406-782-8150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9968163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT740441Medicaid
MT740441Medicaid