State of Montana

NPI #1326058207 in Boulder, Montana

Provider Information

NPI Number: 1326058207
Entity Type: Organization
Organization Name: State of Montana
Primary Specialty: Intermediate Care Facility, Intellectual Disabilities
Enumeration Date: Aug 9, 2006
Last Updated: Dec 11, 2025

Practice Location

Address: 310 FOURTH AVENUE
City: Boulder
State: Montana
ZIP Code: 59632-0087
Phone: (406) 225-4410

Authorized Official

Name: MRS. ALEASHA MARTIN
Title: FACILITY REIMBURSEMENT MANAGER
Phone: (406) 444-3416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Intermediate Care Facility, Intellectual Disabilities	315P00000X	Primary

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MS. Pamela June Russell	Intermediate Care Facility, Intellectual Disabilities	Hamilton	AI Deep Dive
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