Provider Demographics
NPI:1144307836
Name:BILLINGS FAIRCHILD CENTER
Entity type:Organization
Organization Name:BILLINGS FAIRCHILD CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-725-3533
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:202 E. MAPLE
Mailing Address - City:BILLINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74630-0367
Mailing Address - Country:US
Mailing Address - Phone:580-725-3533
Mailing Address - Fax:580-725-3889
Practice Address - Street 1:202 E. MAPLE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:OK
Practice Address - Zip Code:74630
Practice Address - Country:US
Practice Address - Phone:580-725-3533
Practice Address - Fax:580-725-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKNH5201-5201315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities