Provider Demographics
NPI:1053563171
Name:FRONTIER HOME HEALTH AND HOSPICE, LLC
Entity type:Organization
Organization Name:FRONTIER HOME HEALTH AND HOSPICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOGUCKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-693-3840
Mailing Address - Street 1:53 RIVER ST
Mailing Address - Street 2:YANKEE PROFESSIONAL BUILDING
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3346
Mailing Address - Country:US
Mailing Address - Phone:203-693-3840
Mailing Address - Fax:203-693-3841
Practice Address - Street 1:800 FRONT ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3309
Practice Address - Country:US
Practice Address - Phone:406-443-4140
Practice Address - Fax:406-447-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1053563171Medicaid
MT1053563171Medicaid