Organization
EMERITUS CORPORATION
Active
Other names
Brookdale Missoula Valley
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER)
(615) 564-8131
Entity
Organization
Contact information
Practice address
3620 AMERICAN WAY, MISSOULA, MT 59808-1379
(406) 542-7009
(406) 542-8043
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10669
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610759
—
MT
05
—
7151614
—
MT
Enumeration date
02/20/2007
Last updated
05/16/2016
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