Provider Demographics
NPI:1508050410
Name:NORTH CENTRAL AREA AGENCY ON AGING
Entity Type:Organization
Organization Name:NORTH CENTRAL AREA AGENCY ON AGING
Other - Org Name:AREA III AGENCY ON AGING
Other - Org Type:Other Name
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-271-7553
Mailing Address - Street 1:600 S MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425-2532
Mailing Address - Country:US
Mailing Address - Phone:406-271-7553
Mailing Address - Fax:406-271-2769
Practice Address - Street 1:600 S MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425-2532
Practice Address - Country:US
Practice Address - Phone:406-271-7553
Practice Address - Fax:406-271-2769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT00086000013Medicare UPIN