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General NPI Number Information
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NPI Number | 1609574227
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Entity Type | Organization
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Legal Business Name | MISSOULA ALF OPERATIONS, LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 3018 RATTLESNAKE DR
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City | MISSOULA
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State | MT
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Zip | 59802-6101
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Country | US
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Telephone | 406-549-0988
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Fax | 406-549-0111
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Provider Business Mailing Address
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Address Line | 4601 NE 77TH AVE STE 300
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City | VANCOUVER
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State | WA
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Zip | 98662-6736
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Country | US
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Telephone | 360-837-0400
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Fax | 360-967-0022
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | YITZCHOK YENOWITZ
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Credential |
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Telephone | 732-769-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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