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General NPI Number Information
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NPI Number | 1285761148
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Entity Type | Organization
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Legal Business Name | BELMONT MANAGEMENT, INC.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 3625 VAUGHN AVE
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City | POCATELLO
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State | ID
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Zip | 83204-2062
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Country | US
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Telephone | 208-233-0016
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Fax |
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Provider Business Mailing Address
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Address Line | 3155 RIVER RD S STE 100
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City | SALEM
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State | OR
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Zip | 97302-9819
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Country | US
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Telephone | 503-362-5235
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Fax | 503-585-3267
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Authorized Official
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Title or Position | CFO
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Name | JASON MCARTHUR
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Credential |
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Telephone | 503-362-5235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 000681691
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License Number State | ID
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