Organization
EVERGREEN AT POLSON, L.L.C.
Active
Parent organization
EMPRES MONTANA HEALTHCARE, LLC
Other names
Polson Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES MONTANA HEALTHCARE, LLC
Authorized official
BRENT WEIL (CEO AND MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
9 14TH AVE W, POLSON, MT 59860-5321
(406) 883-4378
(406) 883-3388
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
—
—
261QH0700X
Hearing and Speech Clinic/Center
3111
MT
261QH0700X
Hearing and Speech Clinic/Center
3582
MT
314000000X
Skilled Nursing Facility
Primary
10145
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310622
—
MT
Enumeration date
05/05/2006
Last updated
03/11/2021
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