AZALEA PLACE ADULT FAMILY HOME (NPI# 1386850899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386850899 |
| Entity Type | Organization |
| Organization Name | AZALEA PLACE ADULT FAMILY HOME |
| Practice Address |
1 Prospect Dr Great Falls MT 59405-4119 |
| Practice Telephone | 4064524500 |
| Practice Fax Number | 4064524500 |
| Mailing Telephone | 4064524500 |
| Mailing Fax Number | 4064524500 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-08-24 |
| Authorized Official Name | MR. ART D SIMONS (ADMINISTRATOR) |
| Authorized Official Telephone | 4064524500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
10900 | MT | Nursing & Custodial Care Facilities |
| Street Address |
1 PROSPECT DR |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59405-4119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
| 1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
| 1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
| 1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
| 1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
| 1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
| 1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
| 1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
| 1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
| Find all providers in zip 59405 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376934133 | The Home Place, LLC | Custodial Care Facility | 401 Seeley Ln, Seeley Lake, MT 59868-8702 | 2015-02-13 |
| 1588096168 | Felicia Anderson | Custodial Care Facility | 33 Garden Lane, Absarokee, MT 59001 | 2013-08-06 |
| 1992075048 | Mt Silcox Adult Care Center | Custodial Care Facility | 210 South Madison Street, Thompson Falls, MT 59873-1737 | 2012-01-06 |
| 1275852964 | Libby's Lodge of Love LLC | Custodial Care Facility | 39042 Us Highway 2, Libby, MT 59923-8103 | 2010-05-20 |
| 1376771485 | Chanda Rochelle Anderson | Custodial Care Facility | 14 Coulee Dr, Livingston, MT 59047-1546 | 2009-06-26 |
| 1104069467 | Kristie Ann Murphy | Custodial Care Facility | 1831 A St, Butte, MT 59701-6010 | 2009-04-15 |
| 1619188810 | Mercy Manor LLC | Custodial Care Facility | 5830 Sypes Canyon Rd, Bozeman, MT 59715-9379 | 2007-05-28 |
| 1043421902 | West Mont | Custodial Care Facility | 2708 Bozeman Ave, Helena, MT 59601-6405 | 2007-05-24 |
| 1083602205 | Benefis Community Hospitals, Inc. | Custodial Care Facility | 915 4th St Nw, Choteau, MT 59422-9123 | 2005-10-11 |
| 1538585369 | The Elkhorn View | Custodial Care Facility | 10 Elkhorn View Dr, Montana City, MT 59634-9704 | 2014-03-18 |
| Find all providers with the same taxonomy | ||||
| City | GREAT FALLS |
| Zip Code | 59405 |
Please comment or provide details below to improve the information on AZALEA PLACE ADULT FAMILY HOME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.