MEDICARE: HI-LINE RETIREMENT CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	10516	MT
2	385H00000X	Respite Care	10515	MT
3	310400000X	Assisted Living Facility	10579	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215950241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HI-LINE RETIREMENT CENTER

Provider Business Mailing Address
First Line	:	801 S 3RD ST E
Second Line	:
City	:	MALTA
State	:	MT
Zip	:	59538-8728
Country	:	US
Telephone Number	:	406-654-1190
Fax Number	:	406-654-2233

Provider Business Practice Location Address
First Line	:	801 S 3RD ST E
Second Line	:
City	:	MALTA
State	:	MT
Zip	:	59538-8728
Country	:	US
Telephone Number	:	406-654-1190
Fax Number	:	406-654-2233

Authorized Official
Title or Position	:	BOARD CHAIRMAN
Name	:	RICK MIKKELSON
Credential	:
Telephone Number	:	406-654-1190

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	12/24/2015

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Directions to “HI-LINE RETIREMENT CENTER ” Practice Location

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