STATE OF MONTANA NPI 1326058207

NPI Information

NPI: 1326058207
Provider Name: STATE OF MONTANA

Doing Business As: MONTANA DEVELOPMENTAL CENTER

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
310 FOURTH AVENUE
BOULDER, MT
ZIP 59632
Phone: (406) 225-4410
Get Directions

STATE OF MONTANA is an intermediate care facility mentally retarded in Boulder, MT. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STATE OF MONTANA NPI is 1326058207. The provider is registered as an organization entity type.
The provider Is Doing Business As Montana Developmental Center.

The provider's business location address is:

310 FOURTH AVENUE
BOULDER, MT
ZIP 59632-087
Phone: (406) 225-4410
Fax: (406) 225-4414

The provider's authorized official is Teddi Everett .
The authorized official title is Fiscal Manager and has the following contact phone number (406) 444-4497.

The enumeration date for this NPI number is 8/9/2006 and was last updated on 5/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		10867	MONTANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000009910	MEDICARE ID-TYPE UNSPECIFIED	MONTANA	PSYCH & MED PROFESS
2	57-2598	MEDICAID	MONTANA
3	57-0095	MEDICAID	MONTANA
4	57-0336	MEDICAID	MONTANA
5	000003385	MEDICARE PIN	MONTANA
6	57-0050	MEDICAID	MONTANA
7	57-0063	MEDICAID	MONTANA
8	M000009910	MEDICARE PIN	MONTANA
9	57-0037	MEDICAID	MONTANA
10	57-0061	MEDICAID	MONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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