Provider Demographics
NPI:1982127387
Name:NORTHEAST MONTANA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:NORTHEAST MONTANA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
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:406-653-6512
Mailing Address - Fax:
Practice Address - Street 1:1000 6TH AVE N
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201-1828
Practice Address - Country:US
Practice Address - Phone:406-653-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2023-11-05
Deactivation Date:2018-05-16
Deactivation Code:
Reactivation Date:2018-06-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy