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General NPI Number Information
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NPI Number | 1396158036
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Entity Type | Organization
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Legal Business Name | COUNTRYWIDE HOMECARE & COMPANIONSHIP
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 3559 EASTSIDE HWY
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City | STEVENSVILLE
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State | MT
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Zip | 59870-6672
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Country | US
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Telephone | 406-370-9171
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Fax |
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Provider Business Mailing Address
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Address Line | 3559 EASTSIDE HWY
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City | STEVENSVILLE
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State | MT
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Zip | 59870-6672
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Country | US
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Telephone | 406-370-9171
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANI JEAN HAMEL
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Credential |
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Telephone | 406-370-9171
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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 | 45-5329229
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License Number State | MT
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