NPI 1649497926

Country Home Estate, INC

Organisation Preferred Provider Organization Missoula, MT

Practice location

Address: 1704 S Reserve St, Missoula, MT 59801-4752
Phone: (406) 542-1889
Fax: (406) 549-6848

Authorised official

Name: Mary Lynn Newman
Title: President
Phone: (406) 542-1889

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 11069 (MT)

Other Preferred Provider Organization providers in Montana →

Registry record

NPI: 1649497926
Entity type: Organization
NPI issued: 19 Apr 2007
Record last updated: 24 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.