| Big Sky Life Support | |
|
8420 Pheasant Dr Missoula MT 59808-1012 | |
| (406) 880-0184 | |
| (406) 258-0512 |
| Full Name | Big Sky Life Support |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8420 Pheasant Dr, Missoula, Montana |
| Authorized Official Name and Position | Christopher Paul Buckles (ADMINISTRATOR) |
| Authorized Official Contact | 4068800184 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Sky Life Support 8420 Pheasant Dr Missoula MT 59808-1012 Ph: (406) 880-0184 | Big Sky Life Support 8420 Pheasant Dr Missoula MT 59808-1012 Ph: (406) 880-0184 |
| NPI Number | 1154079366 |
|---|---|
| Provider Enumeration Date | 03/16/2022 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154079366 | NPI | - | NPPES |
| 251S00000X | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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