NPI

1130 Seventeenth Avenue Operations LLC

Doing business as Missouri River Center. NPI 1063459501

Read from the NPPES registry on October 23, 2026.

Facts

Status
Active
Type
Organization
Enumeration date
2006-06-01
Last updated
2016-05-17

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Specialties

Licenses

License MT
12680

Location

Practice location
1130 17th Ave S
City
Great Falls MT
Postal code
59405-4523
Phone
(406) 771-4500

Organization contact

Name
Michael Berg
Title
Assistant Secretary
Phone
(505) 468-4752

Medicare

PECOS
No PECOS enrollment row matched this NPI.

LEIE

No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.

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