Healthcare Provider Details

I. General information

NPI: 1043610009
Provider Name (Legal Business Name): MONTANA INDEPENDENT LIVING PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 GREAT NORTHERN BLVD SUITE 105
HELENA MT
59601-3340
US

IV. Provider business mailing address

825 GREAT NORTHERN BLVD SUITE 105
HELENA MT
59601-3340
US

V. Phone/Fax

Practice location:
  • Phone: 406-442-5755
  • Fax: 406-442-1612
Mailing address:
  • Phone: 406-442-5755
  • Fax: 406-442-1612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SCOTT BIRKENBUEL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 406-442-5755