Provider Demographics
NPI:1053531160
Name:BENEFIS COMMUNITY CARE, INC.
Entity type:Organization
Organization Name:BENEFIS COMMUNITY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:
Authorized Official - Last Name:EHLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-455-5479
Mailing Address - Street 1:1411 9TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4507
Mailing Address - Country:US
Mailing Address - Phone:406-771-6400
Mailing Address - Fax:406-771-8337
Practice Address - Street 1:1411 9TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4507
Practice Address - Country:US
Practice Address - Phone:406-771-6400
Practice Address - Fax:406-771-8337
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEFIS HEALTH SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-30
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0631943Medicaid