Basic Information
Provider Information
NPI: 1982963930
EntityType: 2
ReplacementNPI:  
OrganizationName: BETA FACTOR HOME CARE, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: COMPASSUS HOME HEALTH BUTTE MT
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10 CADILLAC DRIVE
Address2: SUITE 400
City: BRENTWOOD
State: TN
PostalCode: 370271001
CountryCode: US
TelephoneNumber: 6153777022
FaxNumber: 6153734457
Practice Location
Address1: 3745 HARRISON AVE
Address2: SUITE G
City: BUTTE
State: MT
PostalCode: 597016814
CountryCode: US
TelephoneNumber: 4064940039
FaxNumber: 4064940032
Other Information
ProviderEnumerationDate: 05/11/2012
LastUpdateDate: 06/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ADKINS
AuthorizedOfficialFirstName: RUSSELL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SVP GENERAL COUNSEL
AuthorizedOfficialTelephone: 6153095668
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


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