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Organization
COUNTY OF TETON
Active
Organization
COUNTY OF TETON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARLENE RENEE WOLBAUM (ADMINISTRATOR)
(406) 466-5338
Entity
Organization
Contact information
Practice address
24 MAIN AVE N, CHOTEAU, MT 59422
(406) 466-5338
(406) 466-5898
Mailing address
PO BOX 317, CHOTEAU, MT 59422-0317
(406) 466-5338
(406) 466-5898
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
10074
MT
314000000X
Skilled Nursing Facility
Primary
10074
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-5075
MEDICARE
MT
05
—
31-8604
—
MT
Enumeration date
11/01/2005
Last updated
12/14/2012
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