Provider Demographics
NPI:1396158036
Name:COUNTRYWIDE HOMECARE & COMPANIONSHIP
Entity type:Organization
Organization Name:COUNTRYWIDE HOMECARE & COMPANIONSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANI
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-370-9171
Mailing Address - Street 1:3559 EASTSIDE HWY
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6672
Mailing Address - Country:US
Mailing Address - Phone:406-370-9171
Mailing Address - Fax:
Practice Address - Street 1:3559 EASTSIDE HWY
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6672
Practice Address - Country:US
Practice Address - Phone:406-370-9171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT45-5329229251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health