# GLENDIVE NURSING AND REHAB CENTER, LLC

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093451841
- **Authorized official:** DUSTIN MONROE (GENERAL COUNSEL)
- **Authorized official phone:** (385) 240-6408

## Contact information

- **Practice address:** 2000 MONTANA AVE, GLENDIVE, MT 59330-3700
- **Practice address phone:** (385) 240-6408
- **Mailing address:** 1376 E 3300 S, SALT LAKE CITY, UT 84106-3069
- **Mailing address phone:** (385) 240-6408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261Q00000X | Clinic/Center | — | — | — |
| 261QH0700X | Hearing and Speech Clinic/Center | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | — | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2022
- **Last updated:** 06/19/2023