NPI 1326058207

State of Montana

Organisation Intellectual Disabilities Intermediate Care Facility Boulder, MT

Practice location

Address: 310 Fourth Avenue, Boulder, MT 59632-0087
Phone: (406) 225-4410
Fax: (406) 225-4414
Mailing address: 111 N Sanders St Dept 30, Helena, MT 59601-4520

Authorised official

Name: Aleasha Martin
Title: Facility Reimbursement Manager
Phone: (406) 444-3416

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 10867 (MT)

Other Intermediate Care Facility, Intellectual Disabilities providers in Montana →

Registry record

NPI: 1326058207
Entity type: Organization
NPI issued: 9 Aug 2006
Record last updated: 11 Dec 2025

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.