Organization
EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC
Active
Other names
ESGW Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SHERMAN (CFO)
(406) 771-3762
Entity
Organization
Contact information
Practice address
524 S 9TH AVE STE 103, CALDWELL, ID 83605-5072
(208) 454-8555
(208) 454-8828
Mailing address
425 1ST AVE N, GREAT FALLS, MT 59401-2507
(406) 771-3754
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/30/2013
Last updated
08/19/2026
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