NPIMap

Organization Active NPI

Easterseals-Goodwill Northern Rocky Mountain, Inc.

  • Home Health Agency
  • Great Falls, MT
National Provider Identifier
1104953868
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC.
Practice address
425 1St Ave N
Great Falls, MT 59401-2507
Phone
(406) 454-3883
Fax
(406) 454-3235
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Authorized official

Name
Mark Sherman
Title
Cfo
Phone
(406) 771-3762

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MT
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

425 1St Ave N
Great Falls, MT 59401-2507

Mailing address

425 1St Ave N
Great Falls, MT 59401-2507
Phone (406) 761-3680

Other practice location 1

4400 Central Ave
Great Falls, MT 59405-1641
Phone (406) 761-3680

Other identifiers 1

IdentifierTypeStateIssuer
805011100MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Montana Easter Seal Soc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1104953868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594012507",
            "telephone_number": "406-761-3680",
            "fax_number": "406-761-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594012507",
            "telephone_number": "406-454-3883",
            "fax_number": "406-454-3235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594051641",
            "country_code": "US",
            "telephone_number": "406-761-3680",
            "fax_number": "406-452-4850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "406-771-3762"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MT",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805011100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.