# POWDER RIVER COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Powder River Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386611747
- **Authorized official:** MRS. KESA COPPS (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (406) 436-2646

## Contact information

- **Practice address:** 104 N. TRAUTMAN STREET, BOX 719, BROADUS, MT 59317-0719
- **Practice address phone:** (406) 436-2646
- **Practice address fax:** (406) 436-2923
- **Mailing address:** PO BOX 719, 104 N. TRAUTMAN, BROADUS, MT 59317-0719
- **Mailing address phone:** (406) 436-2646
- **Mailing address fax:** (406) 436-2923

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | — | — |
| 314000000X | Skilled Nursing Facility | 10072 | MT | Yes |

## Other

- **Enumeration date:** 03/03/2006
- **Last updated:** 07/08/2021