# HILLSIDE HEALTH CARE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265597207
- **Authorized official:** JAMES A. WEICHERT (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (952) 361-8000

## Contact information

- **Practice address:** 4720 23RD AVE, MISSOULA, MT 59803-1137
- **Practice address phone:** (406) 251-5100
- **Practice address fax:** (406) 251-4278
- **Mailing address:** 1107 HAZELTINE BLVD STE 200, CHASKA, MN 55318-1070
- **Mailing address phone:** (952) 361-8000
- **Mailing address fax:** (952) 361-8060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 755 | MT | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 10/16/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 217598 | — | MT |
| 01 | — | 2703785 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |