Provider Demographics
NPI:1922007756
Name:FLATHEAD COUNTY HOME HEALTH
Entity Type:Organization
Organization Name:FLATHEAD COUNTY HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-751-8101
Mailing Address - Street 1:736 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5342
Mailing Address - Country:US
Mailing Address - Phone:406-751-6800
Mailing Address - Fax:406-751-6807
Practice Address - Street 1:736 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5342
Practice Address - Country:US
Practice Address - Phone:406-751-6800
Practice Address - Fax:406-751-6807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10111251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000740311Medicaid
MT0000740311Medicaid