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General NPI Number Information
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NPI Number | 1902403710
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Entity Type | Organization
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Legal Business Name | TETON PEAK ASSISTED
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 24 MAIN AVE N
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City | CHOTEAU
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State | MT
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Zip | 59422-9008
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Country | US
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Telephone | 406-466-3033
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Fax | 406-466-3020
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Provider Business Mailing Address
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Address Line | PO BOX 989
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City | CHOTEAU
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State | MT
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Zip | 59422-0989
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Country | US
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Telephone | 406-466-3033
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Fax | 406-466-3010
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHANEL MARONEY
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Credential | LPN
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Telephone | 406-466-3033
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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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