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1130 SEVENTEENTH AVENUE OPERATIONS LLC

Alzheimer Center

Great Falls, Montana

Provider NPI: 1063459501

Organization Information:
Organization Name:  1130 SEVENTEENTH AVENUE OPERATIONS LLC


Practice Location:
1130 17TH AVE S  GREAT FALLS, MT 59405 US
Tel: 406-771-4500  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
MT12680

Other Provider Identifiers:

IssuerNumberStateType
BC/BS41502MT01
3400969MT05
3400982MT05
310301MT05
0534548MT05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ALZHEIMERS JOBS MT - Page 1



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