Provider Demographics
NPI:1295461606
Name:HOMESTEAD HEALTH, LLC
Entity Type:Organization
Organization Name:HOMESTEAD HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, RN
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:SUSANNE MARIE
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-852-0343
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:CIRCLE
Mailing Address - State:MT
Mailing Address - Zip Code:59215-0245
Mailing Address - Country:US
Mailing Address - Phone:406-852-0343
Mailing Address - Fax:
Practice Address - Street 1:903 HORSE CREEK RD
Practice Address - Street 2:
Practice Address - City:CIRCLE
Practice Address - State:MT
Practice Address - Zip Code:59215-7123
Practice Address - Country:US
Practice Address - Phone:406-852-0343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health