Provider Demographics
NPI:1265499297
Name:NEW WESTERN MANOR COMPANY LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:NEW WESTERN MANOR COMPANY LIMITED PARTNERSHIP
Other - Org Name:BILLINGS HEALTH & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-361-8000
Mailing Address - Street 1:1107 HAZELTINE BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1009
Mailing Address - Country:US
Mailing Address - Phone:952-361-8000
Mailing Address - Fax:952-361-8058
Practice Address - Street 1:2115 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4741
Practice Address - Country:US
Practice Address - Phone:406-656-6500
Practice Address - Fax:406-652-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9415314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0534183Medicaid
MT0343161Medicaid
MT0318760Medicaid
MT621078Medicaid
4011-2OtherBCBS OF MONTANA
MT0222690Medicaid
MT0222690Medicaid
MT0347386Medicare ID - Type UnspecifiedOT