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General NPI Number Information
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NPI Number | 1295461606
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HEALTH, LLC
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 903 HORSE CREEK RD
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City | CIRCLE
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State | MT
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Zip | 59215-7123
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Country | US
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Telephone | 406-852-0343
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 245
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City | CIRCLE
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State | MT
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Zip | 59215-0245
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Country | US
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Telephone | 406-852-0343
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Fax |
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Authorized Official
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Title or Position | OWNER, RN
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Name | LATOYA SUSANNE MARIE GARDNER
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Credential | RN
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Telephone | 406-852-0343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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