Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA GUCKENBERG (OWNER)
(406) 250-3941
Entity
Organization
Contact information
Practice address
144 TOBACCO VALLEY VIEW DRIVE, EUREKA, MT 59917
(140) 688-2461
Mailing address
PO BOX 1911, EUREKA, MT 59917-1911
(140) 688-2461
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
MT
310400000X
Assisted Living Facility
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
MT
Other
Enumeration date
11/22/2010
Last updated
05/02/2023
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