MEDICARE: THANKFULLY, 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	253Z00000X	In Home Supportive Care Agency	DNA	MT
2	251E00000X	Home Health Agency	DNA	MT

General Provider Information

NPI Number	:	1710323308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THANKFULLY, INC

Provider Business Mailing Address
First Line	:	PO BOX 1893
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59903-1893
Country	:	US
Telephone Number	:	406-871-1946
Fax Number	:	406-420-2008

Provider Business Practice Location Address
First Line	:	14132 PINE ST
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-8402
Country	:	US
Telephone Number	:	406-871-1946
Fax Number	:	406-420-2008

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MS. ALIDA MARIE TINCH
Credential	:
Telephone Number	:	406-871-1946

Provider Enumeration Date	:	05/22/2013
Last Update Date	:	05/22/2013

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Directions to “THANKFULLY, INC ” Practice Location

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