Healthcare Provider Details

I. General information

NPI: 1669353082
Provider Name (Legal Business Name): SUN RIVER HEALTH AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 17TH AVE S
GREAT FALLS MT
59405-4523
US

IV. Provider business mailing address

947 S 500 E STE 105
AMERICAN FORK UT
84003-3392
US

V. Phone/Fax

Practice location:
  • Phone: 801-360-8804
  • Fax:
Mailing address:
  • Phone: 801-360-8804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: WENDY ANDERSON
Title or Position: CORPORATE BUSINESS DIRECTOR
Credential:
Phone: 801-360-8804