Healthcare Provider Details

I. General information

NPI: 1336432509
Provider Name (Legal Business Name): BITTERROOT VALLEY DEVELOPMENTAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2011
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 N 1ST ST STE C
HAMILTON MT
59840-2542
US

IV. Provider business mailing address

1720 N 1ST ST STE C
HAMILTON MT
59840-2542
US

V. Phone/Fax

Practice location:
  • Phone: 406-370-0817
  • Fax:
Mailing address:
  • Phone: 406-370-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE MARIE ALBRIGHT
Title or Position: OWNER
Credential:
Phone: 406-370-0817