Organization
IVY AT GREAT FALLS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN MORRIS COANE (CHIEF OPERATING OFFICER)
(305) 912-9260
Entity
Organization
Contact information
Practice address
1130 17TH AVE S, GREAT FALLS, MT 59405-4523
(406) 771-4500
Mailing address
9429 HARDING AVE # 141, SURFSIDE, FL 33154-2803
(305) 912-9260
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/09/2019
Last updated
01/12/2021
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