Provider Demographics
NPI:1710286596
Name:HOME HEALTH OF MONTANA PRIVATE SERVICES LLC
Entity Type:Organization
Organization Name:HOME HEALTH OF MONTANA PRIVATE SERVICES LLC
Other - Org Name:IT STARTS WITH ME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, RN
Authorized Official - Phone:406-541-2036
Mailing Address - Street 1:29 FORT MISSOULA ROAD
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804
Mailing Address - Country:US
Mailing Address - Phone:406-541-2036
Mailing Address - Fax:406-203-0863
Practice Address - Street 1:29 FORT MISSOULA ROAD
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804
Practice Address - Country:US
Practice Address - Phone:406-541-2036
Practice Address - Fax:406-532-1861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-20
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health