Basic Information
| Provider Information | |||||||||
| NPI: | 1255532313 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PONDEROSA HEALTH CARE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1341 ROSEBUD LN | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591016527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062526135 | ||||||||
| FaxNumber: | 4062597098 | ||||||||
| Practice Location | |||||||||
| Address1: | 1341 ROSEBUD LN | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591016527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062526135 | ||||||||
| FaxNumber: | 4062597098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 02/08/2013 | ||||||||
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| AuthorizedOfficialLastName: | FOLEY | ||||||||
| AuthorizedOfficialFirstName: | BRENDAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8609895053 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | MT | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.