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General NPI Number Information
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NPI Number | 1225305261
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Entity Type | Organization
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Legal Business Name | BOZEMAN PARTNERS LLC -DBA-
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Dates
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Enumeration Date | 11/18/2011
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 1641 HUNTERS WAY
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City | BOZEMAN
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State | MT
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Zip | 59718
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Country | US
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Telephone | 406-586-0074
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Fax |
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Provider Business Mailing Address
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Address Line | 111 MARKET STREET NE STE 200
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City | OLYMPIA
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State | WA
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Zip | 98501
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Country | US
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Telephone | 360-867-1900
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. EMMETT AARON KOELSCH
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Credential |
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Telephone | 360-867-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 12335
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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