Masonic Home of Montana, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

10266 Issued in MT

Legal business name

MASONIC HOME OF MONTANA, INC.

Practice address

2010 Masonic Home Rd
Helena, MT 59602-9517

Phone

(406) 458-5461

NPI assigned

Feb 24, 2008

Organization subpart

No

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

Authorized official

Name

Marcy S. Fortner

Title

Administrator

Phone

(406) 458-5431

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1203811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227225600000",
    "number": "1326217340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 MASONIC HOME RD",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596029517",
            "telephone_number": "406-458-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 MASONIC HOME RD",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596029517",
            "telephone_number": "406-458-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASONIC HOME OF MONTANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-24",
        "last_updated": "2008-11-21",
        "status": "A",
        "authorized_official_last_name": "FORTNER",
        "authorized_official_first_name": "MARCY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "406-458-5431"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MT",
            "license": "10266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0650522",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Helena, MT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.