Healthcare Provider Details

I. General information

NPI: 1588683866
Provider Name (Legal Business Name): SWEET MEMORIAL NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 2 WEST
CHINOOK MT
59523
US

IV. Provider business mailing address

PO BOX 1149
CHINOOK MT
59523-1149
US

V. Phone/Fax

Practice location:
  • Phone: 406-357-2549
  • Fax:
Mailing address:
  • Phone: 406-357-2549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number9960
License Number StateMT

VIII. Authorized Official

Name: MRS. JENNI PULA
Title or Position: ADMINISTRATOR
Credential:
Phone: 406-357-2549