# MOUNTRAIL BETHEL HOME, INC.

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

## Provider details

- **NPI number:** 1184712002
- **Authorized official:** STEPHANIE EVERETT (CEO/ADMINISTRATOR)
- **Authorized official phone:** (701) 682-2424

## Contact information

- **Practice address:** 615 6TH ST SE, STANLEY, ND 58784-4444
- **Practice address phone:** (701) 628-2442
- **Practice address fax:** (701) 628-3990
- **Mailing address:** PO BOX 700, STANLEY, ND 58784-0700
- **Mailing address phone:** (701) 628-2442
- **Mailing address fax:** (701) 628-3990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 06/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 030032 | — | ND |
| 05 | — | 1456667 | — | ND |