Provider Demographics
NPI:1366408023
Name:MOUNTAIN VIEW CARE CENTER, INC
Entity type:Organization
Organization Name:MOUNTAIN VIEW CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE JOY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-676-5510
Mailing Address - Street 1:829 MAIN ST SW
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-2504
Mailing Address - Country:US
Mailing Address - Phone:406-676-5510
Mailing Address - Fax:406-676-5512
Practice Address - Street 1:829 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2504
Practice Address - Country:US
Practice Address - Phone:406-676-5510
Practice Address - Fax:406-676-5512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10512314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0310913Medicaid
MT275148Medicare ID - Type Unspecified