Healthcare Provider Details

I. General information

NPI: 1619325016
Provider Name (Legal Business Name): HESTIA IN-HOME SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SW HIGGINS AVE STE 102
MISSOULA MT
59803-1489
US

IV. Provider business mailing address

700 SW HIGGINS AVE STE 102
MISSOULA MT
59803-1489
US

V. Phone/Fax

Practice location:
  • Phone: 406-540-4302
  • Fax: 406-540-4306
Mailing address:
  • Phone: 406-540-4302
  • Fax: 406-540-4306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER GRAHAM
Title or Position: CEO
Credential:
Phone: 406-702-1742