Healthcare Provider Details

I. General information

NPI: 1821017765
Provider Name (Legal Business Name): COUNTY OF GARFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 LEAVITT AVE
JORDAN MT
59337
US

IV. Provider business mailing address

332 LEAVITT AVE PO BOX 389
JORDAN MT
59337
US

V. Phone/Fax

Practice location:
  • Phone: 406-557-2500
  • Fax: 406-557-2950
Mailing address:
  • Phone: 406-557-2500
  • Fax: 406-557-2950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number9579
License Number StateMT

VIII. Authorized Official

Name: RONALD BARNES
Title or Position: ADMIN
Credential:
Phone: 406-557-2500