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Organization

STRAWBERRY ROAN STABLE LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACQUELINE MAE RIVERA RN (ADMINISTRATOR)
(406) 473-2206
Entity
Organization

Contact information

Practice address
109 HIGH ST, BOX 87, JUDITH GAP, MT 59453-7701
(406) 473-2206
(406) 473-2207
Mailing address
109 HIGH STREET, BOX 87, JUDITH GAP, MT 59453-5945
(406) 473-2206
(406) 473-2207

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
310400000X
Assisted Living Facility
Primary
13378
MT

Other

Enumeration date
07/09/2015
Last updated
04/15/2024
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