MEDICARE: HEART OF GOLD HOME HEALTHCARE SERVICES OF MONTANA

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1710769039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF GOLD HOME HEALTHCARE SERVICES OF MONTANA

Provider Business Mailing Address
First Line	:	219 N 19TH AVE
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-3981
Country	:	US
Telephone Number	:	800-375-1066
Fax Number	:	800-375-1066

Provider Business Practice Location Address
First Line	:	219 N 19TH AVE
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-3981
Country	:	US
Telephone Number	:	800-375-1066
Fax Number	:	800-375-1066

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEONDRALIQUE GREENE
Credential	:
Telephone Number	:	817-401-7344

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	06/08/2026

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