Healthcare Provider Details

I. General information

NPI: 1710323308
Provider Name (Legal Business Name): THANKFULLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14132 PINE ST
BIGFORK MT
59911-8402
US

IV. Provider business mailing address

PO BOX 1893
KALISPELL MT
59903-1893
US

V. Phone/Fax

Practice location:
  • Phone: 406-871-1946
  • Fax: 406-420-2008
Mailing address:
  • Phone: 406-871-1946
  • Fax: 406-420-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberDNA
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberDNA
License Number StateMT

VIII. Authorized Official

Name: MS. ALIDA MARIE TINCH
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 406-871-1946