Healthcare Provider Details

I. General information

NPI: 1740510841
Provider Name (Legal Business Name): LIVING LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 2ND AVE N STE 232
GREAT FALLS MT
59401-3286
US

IV. Provider business mailing address

1601 2ND AVE N STE 232
GREAT FALLS MT
59401-3286
US

V. Phone/Fax

Practice location:
  • Phone: 406-216-3100
  • Fax: 406-216-2139
Mailing address:
  • Phone: 406-216-3100
  • Fax: 406-216-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberLIVGLIFE
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberLIVGLIFE
License Number StateMT

VIII. Authorized Official

Name: MS. KIMBERLY LYNN SCHOBERG
Title or Position: OWNER
Credential:
Phone: 406-216-3100