Provider Demographics
NPI:1346479128
Name:PARKHAVEN RETIREMENT COMMUNITY LLC
Entity Type:Organization
Organization Name:PARKHAVEN RETIREMENT COMMUNITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:406-282-7488
Mailing Address - Street 1:100 HAMILTON CT
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:MT
Mailing Address - Zip Code:59741-8160
Mailing Address - Country:US
Mailing Address - Phone:406-282-7488
Mailing Address - Fax:406-284-9938
Practice Address - Street 1:100 HAMILTON CT
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:MT
Practice Address - Zip Code:59741-8160
Practice Address - Country:US
Practice Address - Phone:406-282-7488
Practice Address - Fax:406-284-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11860310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility