NPIMap

Organization Active NPI

Easterseals-Goodwill Northern Rocky Mountain, Inc

  • In Home Supportive Care Agency
  • Great Falls, MT
National Provider Identifier
1871159699
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC
Practice address
425 1St Ave N
Great Falls, MT 59401-2507
Phone
(406) 761-3680
Fax
(406) 761-1390
NPI assigned
May 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Susan Dorr
Title
Director of Billing & Reimbursement
Phone
(406) 771-3754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

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

Mailing address

PO Box 2509
Great Falls, MT 59403-2509
Phone (406) 761-3680

Other practice location 1

3703 Harrison Ave
Butte, MT 59701-6897
Phone (406) 533-0020

Other practice location 2

305 Main Ave N
Choteau, MT 59422-9074
Phone (406) 466-2088

Other identifiers 3

IdentifierTypeStateIssuer
167648MedicaidNE
121732MedicaidMT
138320MedicaidMT

Other names 1

  • Personal Care Other name

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": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1871159699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2509",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594032509",
            "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": "406-761-3680",
            "fax_number": "406-761-1390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3703 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Butte",
            "state": "MT",
            "postal_code": "597016897",
            "country_code": "US",
            "telephone_number": "406-533-0020",
            "fax_number": "406-761-1390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Main Ave N",
            "address_purpose": "LOCATION",
            "city": "Choteau",
            "state": "MT",
            "postal_code": "594229074",
            "country_code": "US",
            "telephone_number": "406-466-2088",
            "fax_number": "406-761-1390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "DORR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING & REIMBURSEMENT",
        "authorized_official_telephone_number": "406-771-3754"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167648",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121732",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138320",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 16, 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.