Organization
PROVIDENCE ST JOSEPH MEDICAL CENTER
Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
Prov St Joseph Med Ctr RC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
11 17TH AVE E, POLSON, MT 59860-4083
(406) 883-1011
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
(406) 883-1011
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10123
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
810628
—
MT
Enumeration date
12/15/2006
Last updated
04/05/2025
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