Organization
EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC
Active
Other names
Personal Care
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DORR (DIRECTOR OF BILLING & REIMBURSEMENT)
(406) 771-3754
Entity
Organization
Contact information
Practice address
425 1ST AVE N, GREAT FALLS, MT 59401-2507
(406) 761-3680
(406) 761-1390
Mailing address
PO BOX 2509, GREAT FALLS, MT 59403-2509
(406) 761-3680
(406) 761-1390
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121732
—
MT
05
—
138320
—
MT
05
—
167648
—
NE
Enumeration date
05/16/2019
Last updated
05/16/2019
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