MEDICARE: RE FAMILY SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1023669413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RE FAMILY SERVICES INC.

Provider Business Mailing Address
First Line	:	PO BOX 6226
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59406-6226
Country	:	US
Telephone Number	:	406-204-1487
Fax Number	:	406-315-3845

Provider Business Practice Location Address
First Line	:	11 5TH ST N STE 201
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3269
Country	:	US
Telephone Number	:	406-204-1487
Fax Number	:	406-315-3845

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TYSON WILKE
Credential	:
Telephone Number	:	406-204-1487

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	02/25/2020

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Directions to “RE FAMILY SERVICES INC. ” Practice Location

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