Healthcare Provider Details

I. General information

NPI: 1356055792
Provider Name (Legal Business Name): CENTRAL MONTANA SNF OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 WENDELL AVE
LEWISTOWN MT
59457-2261
US

IV. Provider business mailing address

4601 NE 77TH AVE STE 300
VANCOUVER WA
98662-6736
US

V. Phone/Fax

Practice location:
  • Phone: 406-535-6225
  • Fax: 732-523-5312
Mailing address:
  • Phone: 360-837-0400
  • Fax: 360-967-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: YITZCHOK YENOWITZ
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 347-693-4239