# EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Personal Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871159699
- **Authorized official:** SUSAN DORR (DIRECTOR OF BILLING & REIMBURSEMENT)
- **Authorized official phone:** (406) 771-3754

## Contact information

- **Practice address:** 425 1ST AVE N, GREAT FALLS, MT 59401-2507
- **Practice address phone:** (406) 761-3680
- **Practice address fax:** (406) 761-1390
- **Mailing address:** PO BOX 2509, GREAT FALLS, MT 59403-2509
- **Mailing address phone:** (406) 761-3680
- **Mailing address fax:** (406) 761-1390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/16/2019
- **Last updated:** 05/16/2019