Organization
BIG SKY LIFE SUPPORT HCBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PAUL BUCKLES HCA (EXECUTIVE DIRECTOR)
(406) 880-0184
Entity
Organization
Contact information
Practice address
8420 PHEASANT DR, MISSOULA, MT 59808-1012
(406) 880-0081
(406) 258-0512
Mailing address
8420 PHEASANT DR, MISSOULA, MT 59808-1012
(406) 880-0081
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171W00000X
Contractor
Primary
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
08/24/2023
Last updated
01/25/2024
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