MEDICARE: LIVING CENTRE LIMITED

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	310400000X	Assisted Living Facility	D239038-1435560	MT
2	314000000X	Skilled Nursing Facility	D239068-1435560	MT

General Provider Information

NPI Number	:	1497197438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING CENTRE LIMITED

Provider Business Mailing Address
First Line	:	63 MAIN ST
Second Line	:
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2122
Country	:	US
Telephone Number	:	406-363-2273
Fax Number	:	406-363-2709

Provider Business Practice Location Address
First Line	:	63 MAIN ST
Second Line	:
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2122
Country	:	US
Telephone Number	:	406-363-2273
Fax Number	:	406-363-2709

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JONATHAN WEMPLE
Credential	:
Telephone Number	:	406-777-5411

Provider Enumeration Date	:	07/18/2013
Last Update Date	:	03/18/2019

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