Organization
LUXE HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABRINA DARICEK (OWNER)
(808) 278-8258
Entity
Organization
Contact information
Practice address
1715 S RESERVE ST STE B, MISSOULA, MT 59801-4708
(406) 304-3015
(406) 304-3096
Mailing address
1715 S RESERVE ST STE B, MISSOULA, MT 59801-4708
(406) 304-3096
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021-MSS-GEN-00127
BUSINESS LICENSE
MT
01
—
PY6W2X5J7
SHONDRA BROST, MEDICAL ASSISTANT LICENSE
MT
Enumeration date
01/13/2022
Last updated
09/13/2022
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