Provider Demographics
NPI:1336149517
Name:HOSPICE OF MONTANA III LLC
Entity type:Organization
Organization Name:HOSPICE OF MONTANA III LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-671-5686
Mailing Address - Street 1:3737 GRAND AVENUE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-671-5686
Mailing Address - Fax:406-702-1842
Practice Address - Street 1:3475 MONROE AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701
Practice Address - Country:US
Practice Address - Phone:406-702-1742
Practice Address - Fax:406-702-1842
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-28
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT750048Medicaid
MT271503Medicare ID - Type Unspecified