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General NPI Number Information
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NPI Number | 1447389077
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Entity Type | Organization
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Legal Business Name | MISSOULA AREA AGENCY ON AGING
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 337 STEPHENS AVE
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City | MISSOULA
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State | MT
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Zip | 59801-3816
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Country | US
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Telephone | 406-728-7682
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Fax | 406-728-7687
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Provider Business Mailing Address
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Address Line | 337 STEPHENS AVE
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City | MISSOULA
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State | MT
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Zip | 59801-3816
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Country | US
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Telephone | 406-728-7682
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Fax | 406-728-7687
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | KIM FRASER
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Credential |
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Telephone | 406-728-7682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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