Provider Demographics
NPI:1568710879
Name:JOURNEYS WITHIN, LLC
Entity Type:Organization
Organization Name:JOURNEYS WITHIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:EADUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-403-0830
Mailing Address - Street 1:1422 20TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-6031
Mailing Address - Country:US
Mailing Address - Phone:406-403-0830
Mailing Address - Fax:
Practice Address - Street 1:1422 20TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-6031
Practice Address - Country:US
Practice Address - Phone:406-403-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTC209442-1114283311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000309961Medicaid