Local City Search for Care Homes, Nursing Homes, Assisted Living, Skilled Nursing and Home CareSTATE OF MONTANA
Intermediate Care Facility, Mentally Retarded
Boulder, Montana
Provider NPI: 1326058207
Organization Information:Organization Name: STATE OF MONTANA
Practice Location:
310 FOURTH AVENUE BOULDER, MT 59632 US
Tel: 406-225-4410 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
310 FOURTH AVENUE BOULDER, MT 59632 US
Tel: 406-225-4410 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | MT | 10867 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 57-0061 | MT | 05 | |
| 57-0037 | MT | 05 | |
| 57-2598 | MT | 05 | |
| 57-0063 | MT | 05 | |
| 57-0050 | MT | 05 | |
| 57-0095 | MT | 05 | |
| 57-0336 | MT | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin