Healthcare Provider Details

I. General information

NPI: 1497197438
Provider Name (Legal Business Name): LIVING CENTRE LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 MAIN ST
STEVENSVILLE MT
59870-2122
US

IV. Provider business mailing address

63 MAIN ST
STEVENSVILLE MT
59870-2122
US

V. Phone/Fax

Practice location:
  • Phone: 406-363-2273
  • Fax: 406-363-2709
Mailing address:
  • Phone: 406-363-2273
  • Fax: 406-363-2709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberD239038-1435560
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberD239068-1435560
License Number StateMT

VIII. Authorized Official

Name: JONATHAN WEMPLE
Title or Position: ADMINISTRATOR
Credential:
Phone: 406-777-5411