<Unavail>

LBN: 1130 Seventeenth Avenue Operations Llc
<Unavail> is an health care organization with primary practice located at 1130 17Th Ave S , Great Falls MT 59405-4523. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. 1130 Seventeenth Avenue Operations Llc can be contacted via phone (406) 771-4500, or through Berg, Michael T. via phone (505) 468-4752.

Contact Information

Primary practice address
1130 17Th Ave S Great Falls MT 59405-4523
Phone: (406) 771-4500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berg, Michael T.
Phone: (505) 468-4752

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 12680 Montana

Profile Details

NPI number 1063459501
LBN Legal business name 1130 Seventeenth Avenue Operations Llc
DBA Doing business as <Unavail>
Authorized official Berg, Michael T.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 1st, 2006
Last updated May 17th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063459501 NPPES
Montana MEDICAID 3400982
Montana MEDICAID 0534548
Montana MEDICAID 310301
Montana MEDICAID 3400969
Montana Other 41502

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