Provider Demographics
NPI:1417723461
Name:CONFEDERATED SALISH & KOOTENAI TRIBES OF THE FLATHEAD RESERVATION
Entity Type:Organization
Organization Name:CONFEDERATED SALISH & KOOTENAI TRIBES OF THE FLATHEAD RESERVATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE RESOURCE DIVISION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-745-3525
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:SAINT IGNATIUS
Mailing Address - State:MT
Mailing Address - Zip Code:59865-0880
Mailing Address - Country:US
Mailing Address - Phone:406-745-3525
Mailing Address - Fax:
Practice Address - Street 1:1303 RIVENDELL CT
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-3368
Practice Address - Country:US
Practice Address - Phone:406-745-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONFEDERATED SALISH & KOOTENAI TRIBES OF THE FLATHEAD RESERVATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility