Provider Demographics
NPI:1851837439
Name:LEWISTON HEALTHCARE 2, LLC
Entity type:Organization
Organization Name:LEWISTON HEALTHCARE 2, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:AMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-873-7958
Mailing Address - Street 1:404 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-3247
Mailing Address - Country:US
Mailing Address - Phone:406-538-3758
Mailing Address - Fax:
Practice Address - Street 1:404 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-3247
Practice Address - Country:US
Practice Address - Phone:406-538-3758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LE HOLDING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility