Provider Demographics
NPI:1932762481
Name:MONTANA ACHIEVEMENT PROJECT
Entity type:Organization
Organization Name:MONTANA ACHIEVEMENT PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLENBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-570-2431
Mailing Address - Street 1:300 N WILLSON AVE STE 402D
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3551
Mailing Address - Country:US
Mailing Address - Phone:406-570-2431
Mailing Address - Fax:
Practice Address - Street 1:300 N WILLSON AVE STE 402D
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3551
Practice Address - Country:US
Practice Address - Phone:406-823-9784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTH RESIDENTIAL HOMES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1972995793Medicaid