NPI 1063459501

1130 Seventeenth Avenue Operations LLC

Organisation Skilled Nursing Facility Great Falls, MT

Practice location

Address: 1130 17th Ave S, Great Falls, MT 59405-4523
Phone: (406) 771-4500

Authorised official

Name: Michael T. Berg
Title: Assistant Secretary
Phone: (505) 468-4752

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 12680 (MT)

Other Skilled Nursing Facility providers in Montana →

Registry record

NPI: 1063459501
Entity type: Organization
NPI issued: 1 Jun 2006
Record last updated: 17 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.