Healthcare Provider Details

I. General information

NPI: 1861758047
Provider Name (Legal Business Name): SAPPHIRE LUTHERAN HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 09/01/2023
Certification Date: 09/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N 10TH ST
HAMILTON MT
59840-2378
US

IV. Provider business mailing address

501 N 10TH ST
HAMILTON MT
59840-2378
US

V. Phone/Fax

Practice location:
  • Phone: 406-363-2800
  • Fax: 406-363-3003
Mailing address:
  • Phone: 406-363-2800
  • Fax: 406-363-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number13124
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number13187
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number13124
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. COLE A HARDEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 406-363-2800