Provider Demographics
NPI:1194855254
Name:ROCKY MOUNTAIN DEVELOPMENT COUNCIL, INC.
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN DEVELOPMENT COUNCIL, INC.
Other - Org Name:AREA IV AGENCY ON AGING
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-447-1680
Mailing Address - Street 1:PO BOX 1717
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-1717
Mailing Address - Country:US
Mailing Address - Phone:406-447-1680
Mailing Address - Fax:
Practice Address - Street 1:200 SOUTH CRUSE AVE.
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-447-1680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0850434Medicaid