Provider Demographics
NPI:1376659946
Name:KALISPELL ACUTE CARE SERVICES LLC
Entity Type:Organization
Organization Name:KALISPELL ACUTE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:G
Authorized Official - Last Name:BECHARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-755-2823
Mailing Address - Street 1:P O BOX 3031
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-3031
Mailing Address - Country:US
Mailing Address - Phone:406-755-2823
Mailing Address - Fax:406-257-4820
Practice Address - Street 1:310 SUNNYVIEW LN
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3129
Practice Address - Country:US
Practice Address - Phone:406-755-2823
Practice Address - Fax:406-257-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8379208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT83544Medicare ID - Type Unspecified