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General NPI Number Information
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NPI Number | 1861328072
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Entity Type | Organization
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Legal Business Name | PINE & RIVER HOME CARE LLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 62 TIMBER RIDGE RD
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City | NOXON
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State | MT
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Zip | 59853-9011
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Country | US
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Telephone | 406-402-1201
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 178
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City | NOXON
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State | MT
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Zip | 59853-0178
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Country | US
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Telephone | 406-402-1201
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES THADDEUS BARRUS
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Credential | CNA
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Telephone | 406-402-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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