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General NPI Number Information
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NPI Number | 1235937939
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Entity Type | Organization
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Legal Business Name | SUMMIT INDEPENDENT LIVING CENTER INC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 3104 W BROADWAY ST
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City | MISSOULA
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State | MT
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Zip | 59808-1614
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Country | US
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Telephone | 406-728-1630
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Fax | 406-829-3309
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Provider Business Mailing Address
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Address Line | 3104 W BROADWAY ST
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City | MISSOULA
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State | MT
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Zip | 59808-1614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FINANCIAL OFFICER
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Name | SCOTT D. FELS
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Credential |
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Telephone | 406-728-1630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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