Healthcare Provider Details

I. General information

NPI: 1245161785
Provider Name (Legal Business Name): ANGEL'S HAVEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5872 EASTSIDE HWY
FLORENCE MT
59833-6942
US

IV. Provider business mailing address

5872 EASTSIDE HWY
FLORENCE MT
59833-6942
US

V. Phone/Fax

Practice location:
  • Phone: 406-317-1042
  • Fax: 435-608-3139
Mailing address:
  • Phone: 406-317-1042
  • Fax: 435-608-3139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LISA R CAMPBELL
Title or Position: OWNER
Credential:
Phone: 406-880-3457