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Organization
IVY AT GREAT FALLS LLC
Active
Organization
IVY AT GREAT FALLS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN MORRIS COANE (CHIEF OPERATING OFFICER)
(305) 912-9260
Entity
Organization
Contact information
Practice address
1130 17TH AVE S, GREAT FALLS, MT 59405-4523
(406) 771-4500
Mailing address
9429 HARDING AVE # 141, SURFSIDE, FL 33154-2803
(305) 912-9260
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/09/2019
Last updated
01/12/2021
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