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General NPI Number Information
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NPI Number | 1942145388
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Entity Type | Organization
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Legal Business Name | HEART OF MONTANA FARM IN THE DELL
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 168 POOR FARM LOOP
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City | LEWISTOWN
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State | MT
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Zip | 59457-8509
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Country | US
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Telephone | 308-880-0086
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 455
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City | LEWISTOWN
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State | MT
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Zip | 59457-0455
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Country | US
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Telephone | 308-880-0086
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | THOMAS PETERSON
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Credential |
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Telephone | 308-880-0086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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