| Strawberry Roan Stable Living Llc | |
|
109 High St Box 87 Judith Gap MT 59453-7701 | |
| (406) 473-2206 | |
| (406) 473-2207 |
| Full Name | Strawberry Roan Stable Living Llc |
|---|---|
| Speciality | Assisted Living Facility |
| Location | 109 High St, Judith Gap, Montana |
| Authorized Official Name and Position | Jacqueline Mae Rivera (ADMINISTRATOR) |
| Authorized Official Contact | 4064732206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Strawberry Roan Stable Living Llc 109 High Street Box 87 Judith Gap MT 59453-5945 Ph: (406) 473-2206 | Strawberry Roan Stable Living Llc 109 High St Box 87 Judith Gap MT 59453-7701 Ph: (406) 473-2206 |
| NPI Number | 1578946471 |
|---|---|
| Provider Enumeration Date | 07/09/2015 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578946471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 310400000X | Assisted Living Facility | 13378 (Montana) | Primary |