| Easterseals-goodwill Northern Rocky Mountain, Inc. | |
|
425 1st Ave N Great Falls MT 59401-2507 | |
| (406) 771-3680 | |
| (406) 761-1390 |
| Full Name | Easterseals-goodwill Northern Rocky Mountain, Inc. |
|---|---|
| Speciality | Nursing Care |
| Location | 425 1st Ave N, Great Falls, Montana |
| Authorized Official Name and Position | Susan Dorr (DIRECTOR OF BILLING & REIMBURSEMENT) |
| Authorized Official Contact | 4067713754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easterseals-goodwill Northern Rocky Mountain, Inc. Po Box 2509 Great Falls MT 59403-2509 Ph: (406) 761-3680 | Easterseals-goodwill Northern Rocky Mountain, Inc. 425 1st Ave N Great Falls MT 59401-2507 Ph: (406) 771-3680 |
| NPI Number | 1114054871 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 02/04/2025 |
| Certification Date | 02/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114054871 | NPI | - | NPPES |
| 691470 | Medicaid | MT | |
| 631709 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251J00000X | Nursing Care | (Montana) | Primary |
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