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Organization
EVERGREEN AT MISSOULA, L.L.C.
Active
Organization
EVERGREEN AT MISSOULA, L.L.C.
Active
Parent organization
EMPRES MONTANA HEALTHCARE, LLC
Other names
Missoula Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES MONTANA HEALTHCARE, LLC
Authorized official
MICHAEL J. MILLER (CFO AND ASSISTANT MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
3018 RATTLESNAKE DR, MISSOULA, MT 59802-6101
(406) 549-0988
(406) 549-0111
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6736
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
MT
310400000X
Assisted Living Facility
—
MT
314000000X
Skilled Nursing Facility
7280
MT
314000000X
Skilled Nursing Facility
Primary
—
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310029
—
MT
Enumeration date
05/05/2006
Last updated
01/20/2022
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