Provider Demographics
NPI:1902800857
Name:DISCOVERY CARE CENTRE LTD
Entity type:Organization
Organization Name:DISCOVERY CARE CENTRE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-363-2273
Mailing Address - Street 1:601 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2060
Mailing Address - Country:US
Mailing Address - Phone:406-363-2273
Mailing Address - Fax:406-363-2709
Practice Address - Street 1:601 N 10TH ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2060
Practice Address - Country:US
Practice Address - Phone:406-363-2273
Practice Address - Fax:406-363-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10190314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT27-5135Medicare Oscar/Certification