Healthcare Provider Details

I. General information

NPI: 1982262960
Provider Name (Legal Business Name): SWEETWATER BUTTE OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CONTINENTAL DR
BUTTE MT
59701-6563
US

IV. Provider business mailing address

662 ENCINITAS BLVD STE 230
ENCINITAS CA
92024-6792
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-6556
  • Fax:
Mailing address:
  • Phone: 760-652-6354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AARON CHESLEY
Title or Position: OWNER
Credential:
Phone: 858-353-3849