1100 Texas Avenue Operations LLC
NPI #1821043621 in Deer Lodge, Montana
Provider Information
- NPI Number
- 1821043621
- Entity Type
- Organization
- Organization Name
- 1100 Texas Avenue Operations LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PEAK MEDICAL MONTANA OPERATIONS LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 23, 2006
- Last Updated
- May 17, 2016
Practice Location
- Address
- 1100 TEXAS AVE
- City
- Deer Lodge
- State
- Montana
- ZIP Code
- 59722-1829
- Phone
- (406) 846-1655
Authorized Official
- Name
- MICHAEL T. BERG
- Title
- ASSISTANT SECRETARY
- Phone
- (505) 468-4752
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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