MEDICARE: MONTANA INDEPENDENT LIVING PROJECT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	251E00000X	Home Health Agency
3	310400000X	Assisted Living Facility
4	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043610009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTANA INDEPENDENT LIVING PROJECT

Provider Business Mailing Address
First Line	:	825 GREAT NORTHERN BLVD
Second Line	:	SUITE 105
City	:	HELENA
State	:	MT
Zip	:	59601-3340
Country	:	US
Telephone Number	:	406-442-5755
Fax Number	:	406-442-1612

Provider Business Practice Location Address
First Line	:	825 GREAT NORTHERN BLVD
Second Line	:	SUITE 105
City	:	HELENA
State	:	MT
Zip	:	59601-3340
Country	:	US
Telephone Number	:	406-442-5755
Fax Number	:	406-442-1612

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	SCOTT BIRKENBUEL
Credential	:
Telephone Number	:	406-442-5755

Provider Enumeration Date	:	08/27/2014
Last Update Date	:	03/25/2026

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