Healthcare Provider Details

I. General information

NPI: 1588653679
Provider Name (Legal Business Name): ST. JOHN'S LUTHERAN MINISTRIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3940 RIMROCK RD
BILLINGS MT
59102-0141
US

IV. Provider business mailing address

3940 RIMROCK RD
BILLINGS MT
59102-0141
US

V. Phone/Fax

Practice location:
  • Phone: 406-655-5600
  • Fax: 406-655-5656
Mailing address:
  • Phone: 406-655-5600
  • Fax: 406-655-5656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number10849
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number10024
License Number StateMT
# 5
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number10959
License Number StateMT
# 6
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number10938
License Number StateMT
# 7
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number10910
License Number StateMT
# 8
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JERRY PEARSALL
Title or Position: CFO
Credential:
Phone: 406-655-5684