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Organization

EVERGREEN AT MISSOULA, L.L.C.

Active
Parent organization
EMPRES MONTANA HEALTHCARE, LLC
Other names
Missoula Health and Rehabilitation Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
EMPRES MONTANA HEALTHCARE, LLC
Authorized official
BRENT WEIL (MANAGER)
(360) 892-6628
Entity
Organization

Contact information

Practice address
3018 RATTLESNAKE DR, MISSOULA, MT 59802-6101
(406) 549-0988
(406) 549-0111
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
(360) 892-6628
(360) 882-5793

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
MT
310400000X
Assisted Living Facility
13184
MT
310400000X
Assisted Living Facility
Primary
MT
314000000X
Skilled Nursing Facility
MT

Other

Enumeration date
07/26/2016
Last updated
02/01/2017
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