Healthcare Provider Details

I. General information

NPI: 1235102013
Provider Name (Legal Business Name): NORTHERN MONTANA CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date: 03/07/2024
Reactivation Date: 03/26/2024

III. Provider practice location address

24 13TH STREET
HAVRE MT
59501
US

IV. Provider business mailing address

P.O. BOX 1231
HAVRE MT
59501
US

V. Phone/Fax

Practice location:
  • Phone: 406-265-2238
  • Fax: 406-265-9046
Mailing address:
  • Phone: 406-262-1302
  • Fax: 406-265-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number10914
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number10914
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: KEVIN HARADA
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 406-265-2211