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1130 Seventeenth Avenue Operations LLC — NPI 1063459501, Great Falls, MT | NPI Central

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NPI 1063459501

OrganizationActive

1130 Seventeenth Avenue Operations LLC

NPI 1063459501 · Skilled Nursing Facility · Great Falls, MT

Provider details

NPI number: 1063459501
Entity type: Organization
Primary specialty: Skilled Nursing FacilityNursing & Custodial Care Facilities
Organization subpart: No
Authorized official: Michael Berg, Assistant Secretary(505) 468-4752
License: 12680 (MT)

Specialties & taxonomies

Skilled Nursing FacilityPrimary314000000XLicense 12680 (MT)
Nursing & Custodial Care Facilities

Practice location

1130 17th Ave S

Great Falls, MT 59405-4523

Phone: (406) 771-4500

Approximate (ZIP-level) locationGet directions

More MT providers

Mailing address

1130 17th Ave S

Great Falls, MT 59405-4523

Other names (DBA / former)

Doing business as: Missouri River Center

Registry dates

Enumerated: 2006-06-01
Last updated: 2016-05-17

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.