Organization
LDYBOSS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRA FISK (OWNER)
(406) 781-4827
Entity
Organization
Contact information
Practice address
1009 3RD AVE N, GREAT FALLS, MT 59401-1507
(406) 781-4827
Mailing address
1009 3RD AVE N, GREAT FALLS, MT 59401-1507
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
310400000X
Assisted Living Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616496
API
MT
05
—
1616496
—
MT
Enumeration date
09/24/2025
Last updated
09/24/2025
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