Organization
NORTH CENTRAL INDEPENDENT LIVING SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM OSBORN (EXECUTIVE DIRECTOR)
(406) 452-9834
Entity
Organization
Contact information
Practice address
1120 25TH AVE, BLACK EAGLE, MT 59414-1037
(406) 452-9834
(406) 453-3940
Mailing address
1120 25TH AVE, BLACK EAGLE, MT 59414-1037
(406) 452-9834
(406) 453-3940
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
MT
310400000X
Assisted Living Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136084
—
MT
05
—
193766
—
MT
Enumeration date
10/06/2015
Last updated
01/17/2024
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