Rae Ann Moxley

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

0044364-001 Issued in MT

Legal business name

RAE ANN MOXLEY

Practice address

459 Conifer Rd
Libby, MT 59923-2966

Phone

(406) 295-9980

NPI assigned

Oct 9, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Rae Ann Moxley

Title

Sole Proprietor

Phone

(406) 293-9980

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grace Assisted Living Other name

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1760734149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 CONIFER RD",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232966",
            "telephone_number": "406-295-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 CONIFER RD",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232966",
            "telephone_number": "406-295-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAE ANN MOXLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-09",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "MOXLEY",
        "authorized_official_first_name": "RAE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "406-293-9980",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MT",
            "license": "0044364-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT ST DEPT. OF PUBLIC HEALTH AND HUMAN SERVICES LICENSE FOR ADULT FOSTER HOME",
            "identifier": "0044364-001",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Assisted Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carolyn Peterson, MA-CCC,SLP
• Nicholas Peterson, DPT
• Nina Petrosyan, MD
• Private Healthcare Facilities
• Samantha Lynn Pyle, MD
• Robert Sterling Rehl, D.D.S
• Gregory A Rice, MD
• Douglas Richardson
• Joel A Riddel, D.C.
• Clara I Riddle, LCPC

• Mental Illness Community Based Residential Treatment Facility in Libby, MT
• Providers in Libby, MT by specialty
• Mental Illness Community Based Residential Treatment Facility in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.