Provider Demographics
NPI:1538658745
Name:AMUNDSON, SARAY CECILIA I (COMMUNITY HEALTH)
Entity Type:Individual
Prefix:MRS
First Name:SARAY
Middle Name:CECILIA
Last Name:AMUNDSON
Suffix:I
Gender:F
Credentials:COMMUNITY HEALTH
Other - Prefix:MRS
Other - First Name:SARAY
Other - Middle Name:CECILIA
Other - Last Name:POLO RUEDA
Other - Suffix:I
Other - Last Name Type:Other Name
Other - Credentials:COMMUNITY HEALTH
Mailing Address - Street 1:3236 LE GRANDE CANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-9602
Mailing Address - Country:US
Mailing Address - Phone:406-266-1190
Mailing Address - Fax:
Practice Address - Street 1:3236 LE GRANDE CANNON BLVD
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-9602
Practice Address - Country:US
Practice Address - Phone:406-266-1190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreter
No171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver
No174H00000XOther Service ProvidersHealth Educator
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle