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General NPI Number Information
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NPI Number | 1689274185
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Entity Type | Organization
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Legal Business Name | PRIMROSE INC
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 1349 LAKE ELMO DR
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City | BILLINGS
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State | MT
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Zip | 59105-1759
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Country | US
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Telephone | 406-601-1106
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Fax | 406-534-7645
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Provider Business Mailing Address
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Address Line | 1349 LAKE ELMO DR
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City | BILLINGS
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State | MT
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Zip | 59105-1759
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Country | US
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Telephone | 406-601-1106
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Fax | 406-534-7645
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | HUNTER JACK JOHNSON
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Credential |
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Telephone | 406-633-1784
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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 |
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License Number State |
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