RAE ANN MOXLEY (NPI# 1760734149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760734149 |
| Entity Type | Organization |
| Organization Name | RAE ANN MOXLEY |
| Other Organization Name | GRACE ASSISTED LIVING |
| Practice Address |
459 Conifer Rd Libby MT 59923-2966 |
| Practice Telephone | 4062959980 |
| Mailing Telephone | 4062959980 |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2012-10-09 |
| Authorized Official Name | MS. RAE ANN MOXLEY (SOLE PROPRIETOR) |
| Authorized Official Telephone | 4062939980 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 0044364-001 | MT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | MT ST DEPT. OF PUBLIC HEALTH AND HUMAN SERVICES LICENSE FOR ADUL | 0044364-001 | 01 |
| Other Name | Type Code |
|---|---|
| Grace Assisted Living | Other Name - Individual/Organization |
| Street Address |
459 CONIFER RD |
| City | LIBBY |
| State | MT |
| Zip Code | 59923-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518504596 | Office of Randy Guinard, Lcsw LLC | Social Worker | 703 California Avenue, Libby, MT 59923 | 2019-12-09 |
| 1952641615 | Kristi Lynn Lovejoy | Massage Therapist | 952 E Spruce, Libby, MT 59923 | 2013-02-18 |
| 1891943981 | Rita Haidle Billow | Psychologist | 320 E. 2nd Street, Libby, MT 59923 | 2008-09-03 |
| 1225229347 | Mark Serra | Emergency Medicine | 350 Louisiana Avenue, Libby, MT 59923 | 2007-08-05 |
| 1992910319 | Joel A Riddel | Chiropractor | 1115 Minnesota Ave, Libby, MT 59923 | 2007-05-10 |
| 1184743056 | Carol J. Kelly | Counselor | 1469 Highway 2 South, Libby, MT 59923 | 2007-03-29 |
| 1578696464 | Robert Hanley | Counselor | 711 California Avenue, Libby, NE 59923 | 2007-03-13 |
| 1851463947 | Steven L Sorensen | Optometrist | 422 Louisiana Ave, Libby, MT 59923 | 2006-11-14 |
| 1295823979 | Clyde Allen Knecht | Family Medicine | 403 Utah Ave, Libby, MT 59923 | 2006-10-10 |
| 1982717625 | Fisher River Volunteer Fire Company | Ambulance | 100 West Camp Road, Libby, MT 59923 | 2006-08-16 |
| Find all providers in zip 59923 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710450044 | Center for Mental Health | Community Based Residential Treatment Facility, Mental Illness | 626 Central Ave W, Great Falls, MT 59404-2851 | 2019-01-09 |
| 1215488325 | Ranch for Kids Project, Inc. | Community Based Residential Treatment Facility, Mental Illness | 144 Gateway Street, Rexford, MT 59930 | 2016-10-24 |
| 1811357767 | New Horizon's Youth Ranch | Community Based Residential Treatment Facility, Mental Illness | 6442 W Kootenai Rd, Rexford, MT 59930-9440 | 2016-03-03 |
| 1306202163 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 7 13th Ave East, Polson, MT 59860 | 2016-01-11 |
| 1124499660 | Gateway Freedom Ranch | Community Based Residential Treatment Facility, Mental Illness | 111 Glen Lake Dr, Eureka, MT 59917-9680 | 2015-10-09 |
| 1316337264 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 45 East 16th Street, Helena, MT 59601 | 2015-01-30 |
| 1568887404 | Selkirk Outdoor Leadership & Education (sole), Inc | Community Based Residential Treatment Facility, Mental Illness | 121 Wisconsin Ave Ste 101, Whitefish, MT 59937-2304 | 2014-03-02 |
| 1881973816 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 1273 Dakota St, Missoula, MT 59801-1709 | 2011-08-09 |
| 1518246552 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 412 Windward Way, Kalispell, MT 59901-2680 | 2011-08-09 |
| 1528363793 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 1404 Westwood Dr, Hamilton, MT 59840-2315 | 2011-01-20 |
| Find all providers with the same taxonomy | ||||
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| 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.