Basic Information
Provider Information
NPI: 1356667216
EntityType: 2
ReplacementNPI:  
OrganizationName: APPLIED HEALTH SERVICES INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: POLSON HEALTH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 102 13TH AVE E
Address2:  
City: POLSON
State: MT
PostalCode: 598603513
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 102 13TH AVE E
Address2:  
City: POLSON
State: MT
PostalCode: 598603513
CountryCode: US
TelephoneNumber: 4067515311
FaxNumber: 4062572010
Other Information
ProviderEnumerationDate: 04/15/2010
LastUpdateDate: 04/15/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STEVENS
AuthorizedOfficialFirstName: VELINDA
AuthorizedOfficialMiddleName: J
AuthorizedOfficialTitleorPosition: CEO/PRESIDENT
AuthorizedOfficialTelephone: 4067521724
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM1300X  Y Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty

No ID Information.


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