# EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC.

> 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:** 1386959575
- **Authorized official:** MARK SHERMAN (CFO)
- **Authorized official phone:** (406) 771-3762

## Contact information

- **Practice address:** 350 S 400 E, SALT LAKE CITY, UT 84111-2908
- **Practice address phone:** (801) 946-1860
- **Mailing address:** 425 1ST AVE N, GREAT FALLS, MT 59401-2507
- **Mailing address phone:** (406) 771-3754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |
| 225XP0200X | Pediatric Occupational Therapist | — | NULL | — |
| 225XP0200X | Pediatric Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 08/11/2010
- **Last updated:** 03/26/2019