NPIMap

Organization Active NPI

Mountain Home Montana Inc

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1265752034
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MOUNTAIN HOME MONTANA INC
Practice address
4720 23Rd Ave
Missoula, MT 59803-1137
Phone
(406) 541-4663
Fax
(406) 541-4662
NPI assigned
Jun 3, 2010
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Greta Jernberg, LCSW
Title
Clinical Director
Phone
(406) 541-4663

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 13491 MT
Clinic/Center 261Q00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Clinical Social Worker 1041C0700X NU Primary
Community/Behavioral Health Agency 251S00000X 709LCSW MT
Community/Behavioral Health Agency 251S00000X 13491 MT

Addresses

Primary practice location

4720 23Rd Ave
Missoula, MT 59803-1137

Mailing address

4720 23Rd Ave
Missoula, MT 59803-1137
Phone (406) 541-4663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260512003165 MT Part B Supplier - Clinic/Group Practice 7416426176 Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

2606 South Ave W
Missoula, MT 59804
Phone (406) 541-4663

4720 23rd Ave
Missoula, MT 59803
Phone (406) 251-5100

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1265752034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 23RD AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031137",
            "telephone_number": "406-541-4663",
            "fax_number": "406-541-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 23RD AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031137",
            "telephone_number": "406-541-4663",
            "fax_number": "406-541-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME MONTANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "JERNBERG",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "406-541-4663",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MT",
            "license": "13491",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MT",
            "license": "709LCSW",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MT",
            "license": "13491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.