# BATES FAMILY DIVERSIFIED, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Three Rivers Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003466822
- **Authorized official:** CYNTHIA A BATES FNP-BC (OWNER)
- **Authorized official phone:** (406) 285-3251

## Contact information

- **Practice address:** 16 RAILWAY AVE, THREE FORKS, MT 59752-9080
- **Practice address phone:** (406) 285-3251
- **Practice address fax:** (406) 285-6742
- **Mailing address:** 16 RAILWAY AVE, THREE FORKS, MT 59752-9080
- **Mailing address phone:** (406) 285-3251
- **Mailing address fax:** (406) 285-6742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2019
- **Last updated:** 08/14/2020