Provider Demographics
NPI:1659806081
Name:INTERIM HEALTHCARE OF WESTERN MONTANA
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF WESTERN MONTANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-884-2006
Mailing Address - Street 1:113 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4217
Mailing Address - Country:US
Mailing Address - Phone:406-884-2006
Mailing Address - Fax:406-884-2009
Practice Address - Street 1:113 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4217
Practice Address - Country:US
Practice Address - Phone:406-884-2006
Practice Address - Fax:406-884-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health