Healthcare Provider Details

I. General information

NPI: 1982127387
Provider Name (Legal Business Name): NORTHEAST MONTANA HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 11/05/2023
Certification Date: 11/05/2023
Deactivation Date: 05/16/2018
Reactivation Date: 06/11/2018

III. Provider practice location address

1000 6TH AVE N
WOLF POINT MT
59201-1828
US

IV. Provider business mailing address

315 KNAPP ST
WOLF POINT MT
59201-1826
US

V. Phone/Fax

Practice location:
  • Phone: 406-653-1400
  • Fax:
Mailing address:
  • Phone: 406-653-6512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD RAY BALAND
Title or Position: CFO
Credential: CPA
Phone: 512-484-4850