Basic Information
| Provider Information | |||||||||
| NPI: | 1598901886 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BUTTE SENIOR LIVING LLC | ||||||||
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| OtherOrganizationName: | BIG SKY SENIOR LIVING COMMUNITY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3723 FAIRVIEW INDUSTRIAL DR SE | ||||||||
| Address2: | SUITE 270 | ||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973021177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033759016 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3701 ELIZABETH WARREN AVE | ||||||||
| Address2: | |||||||||
| City: | BUTTE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597014371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064944900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2008 | ||||||||
| LastUpdateDate: | 12/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | HARDER | ||||||||
| AuthorizedOfficialFirstName: | JON | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5033759016 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | 11504 | MT | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.