Organization
KISMET MILS, LLC
Active
Other names
Friendship Villa Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOORE (CFO)
(605) 642-7736
Entity
Organization
Contact information
Practice address
2300 WILSON ST, MILES CITY, MT 59301
(406) 874-2687
Mailing address
2300 WILSON ST, MILES CITY, MT 59301-5078
(406) 874-2687
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
13520
MT
235Z00000X
Speech-Language Pathologist
4672
MT
314000000X
Skilled Nursing Facility
Primary
9760
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312065
—
MT
Enumeration date
07/26/2005
Last updated
05/14/2019
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