Organization
MILLPOND HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE JEAN STAAT (OWNER)
14067453222
Entity
Organization
Contact information
Practice address
320 MISSION DR, ST IGNATIUS, MT 59865-9676
(406) 745-3222
(406) 745-3222
Mailing address
320 MISSION DR, ST IGNATIUS, MT 59865-9676
(406) 745-3222
(406) 745-3222
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1562063
—
MT
Enumeration date
11/16/2007
Last updated
11/16/2007
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