Healthcare Provider Details

I. General information

NPI: 1639091796
Provider Name (Legal Business Name): SAMARITAN HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 9TH AVE W
KALISPELL MT
59901-4396
US

IV. Provider business mailing address

124 9TH AVE W
KALISPELL MT
59901-4396
US

V. Phone/Fax

Practice location:
  • Phone: 406-257-5284
  • Fax: 140-627-0907
Mailing address:
  • Phone: 406-257-5284
  • Fax: 140-627-0907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: CASSIDY KIPP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 406-257-5284