MEDICARE: DAHL MEMORIAL HEALTHCARE ASSOCIATION INC

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	10660	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

General Provider Information

NPI Number	:	1871642512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAHL MEMORIAL HEALTHCARE ASSOCIATION INC

Provider Business Mailing Address
First Line	:	PO BOX 46
Second Line	:
City	:	EKALAKA
State	:	MT
Zip	:	59324-0046
Country	:	US
Telephone Number	:	406-775-8739
Fax Number	:	406-775-6706

Provider Business Practice Location Address
First Line	:	106 E SANDY ST
Second Line	:
City	:	EKALAKA
State	:	MT
Zip	:	59324-0046
Country	:	US
Telephone Number	:	406-775-8739
Fax Number	:	406-775-6479

Authorized Official
Title or Position	:	CEO
Name	:	RYAN TOOKE
Credential	:
Telephone Number	:	406-775-8730

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	02/18/2022

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