Provider Demographics
NPI:1841325107
Name:NORTHWEST MONTANA HUMAN RESOURCES
Entity type:Organization
Organization Name:NORTHWEST MONTANA HUMAN RESOURCES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAUTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-6565
Mailing Address - Street 1:PO BOX 8300
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-1300
Mailing Address - Country:US
Mailing Address - Phone:406-752-6565
Mailing Address - Fax:406-752-6582
Practice Address - Street 1:214 MAIN ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4454
Practice Address - Country:US
Practice Address - Phone:406-758-5419
Practice Address - Fax:406-755-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT680004Medicaid