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General NPI Number Information
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NPI Number | 1891057477
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Entity Type | Organization
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Legal Business Name | THE HEIGHTS
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 901 BEN HOGAN DR
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City | MISSOULA
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State | MT
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Zip | 59803-2402
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Country | US
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Telephone | 406-829-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 901 BEN HOGAN DR
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City | MISSOULA
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State | MT
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Zip | 59803-2402
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Country | US
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Telephone | 406-829-8262
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NIAOBI RUTH WILBER
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Credential | CNA
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Telephone | 406-829-8262
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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 | 13038
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License Number State | MT
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