Provider Demographics
NPI:1720601115
Name:HOSPICE OF MONTANA II LLC
Entity Type:Organization
Organization Name:HOSPICE OF MONTANA II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-404-2266
Mailing Address - Street 1:5 W MENDENHALL ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3566
Mailing Address - Country:US
Mailing Address - Phone:406-404-2266
Mailing Address - Fax:406-404-2227
Practice Address - Street 1:5 W MENDENHALL ST STE 202
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3566
Practice Address - Country:US
Practice Address - Phone:406-404-2266
Practice Address - Fax:406-404-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based