MEDICARE: IGNITUS MONTANA LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1093647893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IGNITUS MONTANA LLC

Provider Business Mailing Address
First Line	:	608 N 29TH ST
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-1130
Country	:	US
Telephone Number	:	406-381-7376
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 N 29TH ST
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-1130
Country	:	US
Telephone Number	:	406-381-7376
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEMETRIUS JOSLIN
Credential	:
Telephone Number	:	406-381-7376

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “IGNITUS MONTANA LLC ” Practice Location

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