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General NPI Number Information
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NPI Number | 1013102425
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Entity Type | Organization
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Legal Business Name | GREENWOOD ASSISTED LIVING
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 5 GREENWOOD AVE E
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City | BUTTE
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State | MT
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Zip | 59701-5263
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Country | US
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Telephone | 406-782-9004
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Fax | 406-782-9004
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Provider Business Mailing Address
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Address Line | 5 GREENWOOD AVE E
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City | BUTTE
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State | MT
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Zip | 59701-5263
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Country | US
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Telephone | 406-782-9004
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Fax | 406-782-9004
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JULIE TERESA KINDT I
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Credential | B.S.N.
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Telephone | 406-782-9004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 10859
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License Number State | MT
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