HEADWATERS ASSISTED LIVING LLC
NPI 1619683984
Assisted Living Facility in Great Falls, MT
About Headwaters Assisted Living Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HEADWATERS ASSISTED LIVING LLC (NPI 1619683984) is a healthcare organization registered as an assisted living facility in Great Falls, Montana and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through September 5, 2026 and lists Raylene Franklin, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 27D2310632
Headwaters Assisted Living · Great Falls, MTFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Headwaters Assisted Living LLC's NPI number?
The NPI number for Headwaters Assisted Living LLC is 1619683984. It was assigned to this organization in the NPPES registry on January 30, 2023.
Where is Headwaters Assisted Living LLC located?
Headwaters Assisted Living LLC is located at 304 Wilson Butte Rd, Great Falls, MT 59405. The listed phone number is (406) 531-4450.
What is Headwaters Assisted Living LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Headwaters Assisted Living LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 27D2310632) is associated with this NPI, valid through September 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Headwaters Assisted Living LLC was last updated on October 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Headwaters Assisted Living Llc · NPI 1619683984
Assisted Living Facility organization in Great Falls, Montana. Organization record, active in the CMS NPPES registry since January 30, 2023.
## Identity
- **NPI:** 1619683984 (Entity type: Organization)
- **Enumerated:** January 30, 2023
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Organization subpart:** No
- **Authorized official:** Raylene Franklin, OWNER
## Practice location
- **Address:** 304 WILSON BUTTE RD, Great Falls, MT 59405-8404
- **Phone:** (406) 531-4450
## Record status
- **NPPES last updated:** October 11, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1619683984) · Data from the CMS NPPES public registry.