Provider Demographics
NPI:1821016536
Name:NORTHEAST MONTANA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:NORTHEAST MONTANA HEALTH SERVICES, INC.
Other - Org Name:FAITH LUTHERAN HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BALAND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:512-484-4850
Mailing Address - Street 1:315 KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:WOLF POINT
Mailing Address - State:MT
Mailing Address - Zip Code:59201-1826
Mailing Address - Country:US
Mailing Address - Phone:406-653-6500
Mailing Address - Fax:406-653-6593
Practice Address - Street 1:315 KNAPP ST
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201-1826
Practice Address - Country:US
Practice Address - Phone:406-653-6500
Practice Address - Fax:406-653-6593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2023-11-05
Deactivation Date:2018-05-16
Deactivation Code:
Reactivation Date:2018-06-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0413678Medicaid
MT3100552Medicaid
MT0670436Medicaid
MT0442364Medicaid
MT0220235Medicaid
MT0310349Medicaid
MT0442364Medicaid
MT271341Medicare Oscar/Certification