Provider Demographics
NPI:1376809061
Name:NORTH VALLEY HOSPITAL, INC
Entity Type:Organization
Organization Name:NORTH VALLEY HOSPITAL, INC
Other - Org Name:NORTH VALLEY EMBRACE HEALTH A DIVISION OF NORTH VALLEY HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-863-3552
Mailing Address - Street 1:3004 HOSPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-7849
Mailing Address - Country:US
Mailing Address - Phone:406-863-4763
Mailing Address - Fax:
Practice Address - Street 1:3004 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937
Practice Address - Country:US
Practice Address - Phone:406-862-4763
Practice Address - Fax:406-862-4161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM000009945OtherMEDICARE PART B