Organization
HI-LINE RETIREMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK MIKKELSON (BOARD CHAIRMAN)
(406) 654-1190
Entity
Organization
Contact information
Practice address
801 S 3RD ST E, MALTA, MT 59538-8728
(406) 654-1190
(406) 654-2233
Mailing address
801 S 3RD ST E, MALTA, MT 59538-8728
(406) 654-1190
(406) 654-2233
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10579
MT
314000000X
Skilled Nursing Facility
10516
MT
385H00000X
Respite Care
10515
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310930
—
MT
01
—
0700583
MEDICAID WAIVER
MT
Enumeration date
07/25/2006
Last updated
12/24/2015
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