Provider Demographics
NPI:1881996981
Name:HOME SWEET HOME
Entity type:Organization
Organization Name:HOME SWEET HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUCKENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-250-3941
Mailing Address - Street 1:PO BOX 1911
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-1911
Mailing Address - Country:US
Mailing Address - Phone:140-688-2461
Mailing Address - Fax:
Practice Address - Street 1:144 TOBACCO VALLEY VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917
Practice Address - Country:US
Practice Address - Phone:140-688-2461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
MT3104A0630X, 310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances