Healthcare Provider Details

I. General information

NPI: 1831457308
Provider Name (Legal Business Name): BEARCREEK RESPITE CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 E KAGY BLVD
BOZEMAN MT
59715-5834
US

IV. Provider business mailing address

1002 E KAGY BLVD
BOZEMAN MT
59715-5834
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-7002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number12532
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number12884
License Number StateMT

VIII. Authorized Official

Name: MS. MARIAN STEFFES
Title or Position: REGISTERED NURSE/ADMINISTRATOR
Credential:
Phone: 406-587-7002