Provider Demographics
NPI:1336432509
Name:BITTERROOT VALLEY DEVELOPMENTAL SERVICES, LLC
Entity Type:Organization
Organization Name:BITTERROOT VALLEY DEVELOPMENTAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-370-0817
Mailing Address - Street 1:1030 CHERRY ORCHARD LOOP
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-9411
Mailing Address - Country:US
Mailing Address - Phone:406-370-0817
Mailing Address - Fax:
Practice Address - Street 1:1030 CHERRY ORCHARD LOOP
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-9411
Practice Address - Country:US
Practice Address - Phone:406-370-0817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-22
Last Update Date:2011-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No385H00000XRespite Care FacilityRespite Care