Provider Demographics
NPI:1073640330
Name:GLEN-WOOD, INC.
Entity Type:Organization
Organization Name:GLEN-WOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-765-2040
Mailing Address - Street 1:202 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:PLENTYWOOD
Mailing Address - State:MT
Mailing Address - Zip Code:59254-2207
Mailing Address - Country:US
Mailing Address - Phone:406-765-2040
Mailing Address - Fax:406-765-1777
Practice Address - Street 1:202 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:PLENTYWOOD
Practice Address - State:MT
Practice Address - Zip Code:59254-2207
Practice Address - Country:US
Practice Address - Phone:406-765-2040
Practice Address - Fax:406-765-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services