MEDICARE: RIVER'S BEND ASSISTED LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1104604354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER'S BEND ASSISTED LIVING

Provider Business Mailing Address
First Line	:	PO BOX 899
Second Line	:
City	:	SHERIDAN
State	:	MT
Zip	:	59749-0899
Country	:	US
Telephone Number	:	406-842-5133
Fax Number	:	406-842-5651

Provider Business Practice Location Address
First Line	:	801 S 3RD ST E
Second Line	:
City	:	MALTA
State	:	MT
Zip	:	59538-8768
Country	:	US
Telephone Number	:	406-596-3444
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TONY SIMONSEN
Credential	:
Telephone Number	:	406-842-5133

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	09/19/2023

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Directions to “RIVER'S BEND ASSISTED LIVING ” Practice Location

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