NPIMap

Organization Active NPI

Glendive Nursing and Rehab Center, LLC

  • Skilled Nursing Facility
  • Glendive, MT
National Provider Identifier
1093451841
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GLENDIVE NURSING AND REHAB CENTER, LLC
Practice address
2000 Montana Ave
Glendive, MT 59330-3700
Phone
(385) 240-6408
NPI assigned
May 5, 2022
Last updated
Jun 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dustin Monroe
Title
General Counsel
Phone
(385) 240-6408

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X
Clinic/Center 261Q00000X
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X
Occupational Medicine Clinic/Center 261QX0100X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2000 Montana Ave
Glendive, MT 59330-3700

Mailing address

1376 E 3300 S
Salt Lake City, UT 84106-3069
Phone (385) 240-6408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230907001871 MT Part A Provider - Skilled Nursing Facility 9436513512 Practice locations: Glendive, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093451841. Details of each certification follow.

Skilled nursing facility certification: CCN 275144

Legal name
GLENDIVE NURSING AND REHAB CENTER, LLC
Doing business as
EASTERN MONTANA VETERANS HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1995
Last certification
Feb 13, 2025
Beds
80
Ownership / control type
State
Most recent change of ownership
Mar 1, 2023
Organization structure
LLCProprietary
Incorporated
May 5, 2022 in MT
Enrollment address
2000 Montana Ave
Glendive, MT 59330-3700
Nursing home name
EASTERN MONTANA VETERANS HOME
Affiliated entity
EDURO HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Eastern Montana Veterans HomeCCN 275144 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Aug 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8050.0 residents per day on average
Chain
Eduro Healthcare34 facilities in the chain
Penalties (3 years)
3Fines totaling $51,041

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D2188949Eastern Montana Veterans Home2000 Montana Avenue, Glendive, MT 59330Certificate of waiverJul 22, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael C Bewsey Individual 5% Or Greater Indirect Ownership Interest May 5, 2022
Corporate Director Mar 1, 2023 100%
Kari Robinson Individual W-2 Managing EmployeeAdministrator Mar 1, 2023
Joseph M Leal Individual Other Jan 1, 2024
Dustin Monroe Individual Corporate OfficerSecretary Mar 1, 2023
Eduro Healthcare LLC Organization, Salt Lake City, UT LLC 5% Or Greater Direct Ownership Interest May 5, 2022 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1093451841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 E 3300 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063069",
            "telephone_number": "385-240-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MONTANA AVE",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593303700",
            "telephone_number": "385-240-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDIVE NURSING AND REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "385-240-6408"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.