Provider Demographics
NPI:1619325016
Name:HESTIA IN HOME SUPPORT LLC
Entity Type:Organization
Organization Name:HESTIA IN HOME SUPPORT LLC
Other - Org Name:HESTIA HOME ADVANTAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NOONAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-274-3246
Mailing Address - Street 1:700 SW HIGGINS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1489
Mailing Address - Country:US
Mailing Address - Phone:406-540-4302
Mailing Address - Fax:406-540-4306
Practice Address - Street 1:700 SW HIGGINS AVE STE 102
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1489
Practice Address - Country:US
Practice Address - Phone:406-540-4302
Practice Address - Fax:406-540-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty