Healthcare Provider Details

I. General information

NPI: 1821016536
Provider Name (Legal Business Name): NORTHEAST MT HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date: 05/16/2018
Reactivation Date: 06/11/2018

III. Provider practice location address

315 KNAPP ST
WOLF POINT MT
59201-1826
US

IV. Provider business mailing address

315 KNAPP ST
WOLF POINT MT
59201-9998
US

V. Phone/Fax

Practice location:
  • Phone: 406-653-6500
  • Fax: 406-653-6593
Mailing address:
  • Phone: 406-653-6530
  • Fax: 406-653-6593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARY HOVERSLAND
Title or Position: BUSINESS OFFICE DIRECTOR
Credential:
Phone: 406-653-6530