Healthcare Provider Details

I. General information

NPI: 1235483728
Provider Name (Legal Business Name): HOME BASED SERVICES INITIATIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 RIMROCK ROAD
BILLINGS MT
59102-0141
US

IV. Provider business mailing address

3940 RIMROCK ROAD
BILLINGS MT
59102-0141
US

V. Phone/Fax

Practice location:
  • Phone: 406-655-5800
  • Fax:
Mailing address:
  • Phone: 406-655-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number13206
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JERRY PEARSALL
Title or Position: PRESIDENT/CFO
Credential:
Phone: 406-655-5684