Provider Demographics
NPI:1447300132
Name:REGION IV FAMILY OUTREACH, INC
Entity type:Organization
Organization Name:REGION IV FAMILY OUTREACH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINT
Authorized Official - Suffix:
Authorized Official - Credentials:CMBS
Authorized Official - Phone:406-587-2477
Mailing Address - Street 1:1236 HELENA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-2948
Mailing Address - Country:US
Mailing Address - Phone:406-443-3083
Mailing Address - Fax:406-443-3209
Practice Address - Street 1:1236 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-2948
Practice Address - Country:US
Practice Address - Phone:406-443-3083
Practice Address - Fax:406-443-3209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT471053Medicaid
MT651534Medicaid
MT0227903Medicaid