Healthcare Provider Details

I. General information

NPI: 1649663923
Provider Name (Legal Business Name): ALL NATIONS HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W CENTRAL AVE
MISSOULA MT
59801-7931
US

IV. Provider business mailing address

830 W CENTRAL AVE
MISSOULA MT
59801-7931
US

V. Phone/Fax

Practice location:
  • Phone: 406-829-9515
  • Fax: 406-829-9519
Mailing address:
  • Phone: 406-829-9515
  • Fax: 406-829-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: AZURE MCGINTY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 406-829-9515