Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
1130 SEVENTEENTH AVENUE OPERATIONS LLC
Active
Organization
1130 SEVENTEENTH AVENUE OPERATIONS LLC
Active
Other names
Missouri River Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
1130 17TH AVE S, GREAT FALLS, MT 59405-4523
(406) 771-4500
Mailing address
1130 17TH AVE S, GREAT FALLS, MT 59405-4523
(406) 771-4500
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
12680
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0534548
—
MT
05
—
310301
—
MT
05
—
3400969
—
MT
05
—
3400982
—
MT
01
—
41502
BC/BS
MT
Enumeration date
06/01/2006
Last updated
05/17/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers