Provider Demographics
NPI:1902403710
Name:TETON PEAK ASSISTED
Entity Type:Organization
Organization Name:TETON PEAK ASSISTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHANEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARONEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:406-466-3033
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:CHOTEAU
Mailing Address - State:MT
Mailing Address - Zip Code:59422-0989
Mailing Address - Country:US
Mailing Address - Phone:406-466-3033
Mailing Address - Fax:406-466-3010
Practice Address - Street 1:24 MAIN AVE N
Practice Address - Street 2:
Practice Address - City:CHOTEAU
Practice Address - State:MT
Practice Address - Zip Code:59422-9008
Practice Address - Country:US
Practice Address - Phone:406-466-3033
Practice Address - Fax:406-466-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility