Provider Demographics
NPI:1669722021
Name:MOUNTAIN SPRINGS LIVING INC.
Entity type:Organization
Organization Name:MOUNTAIN SPRINGS LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORTED LIVING/HOME CARE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-426-0253
Mailing Address - Street 1:PO BOX 1432
Mailing Address - Street 2:
Mailing Address - City:RED LODGE
Mailing Address - State:MT
Mailing Address - Zip Code:59068-1432
Mailing Address - Country:US
Mailing Address - Phone:406-426-0253
Mailing Address - Fax:406-446-0198
Practice Address - Street 1:215 N COOPER AVE
Practice Address - Street 2:
Practice Address - City:RED LODGE
Practice Address - State:MT
Practice Address - Zip Code:59068-9140
Practice Address - Country:US
Practice Address - Phone:406-671-9678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0044380001320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities