Healthcare Provider Details

I. General information

NPI: 1134894447
Provider Name (Legal Business Name): DISCOVERY CARE CENTRE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N 10TH ST
HAMILTON MT
59840-2060
US

IV. Provider business mailing address

1107 HAZELTINE BLVD # 36
CHASKA MN
55318-1009
US

V. Phone/Fax

Practice location:
  • Phone: 406-363-2273
  • Fax:
Mailing address:
  • Phone: 952-361-8935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES A WEICHERT
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential:
Phone: 952-361-8000