Evergreen at Missoula, L.l.c.

NPI #1538117940 in Missoula, Montana

Provider Information

NPI Number: 1538117940
Entity Type: Organization
Organization Name: Evergreen at Missoula, L.l.c.
Subpart: Yes (part of a larger organization)
Parent Organization: EMPRES MONTANA HEALTHCARE, LLC
Primary Specialty: Occupational Therapist
Enumeration Date: May 5, 2006
Last Updated: Jan 20, 2022

Practice Location

Address: 3018 RATTLESNAKE DR
City: Missoula
State: Montana
ZIP Code: 59802-6101
Phone: (406) 549-0988

Authorized Official

Name: MICHAEL J. MILLER
Title: CFO AND ASSISTANT MANAGER
Phone: (360) 892-6628

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary
Assisted Living Facility	310400000X
Skilled Nursing Facility	314000000X

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