Provider Demographics
NPI:1497197438
Name:LIVING CENTRE LIMITED
Entity Type:Organization
Organization Name:LIVING CENTRE LIMITED
Other - Org Name:THE LIVING CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-777-5411
Mailing Address - Street 1:63 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2122
Mailing Address - Country:US
Mailing Address - Phone:406-363-2273
Mailing Address - Fax:406-363-2709
Practice Address - Street 1:63 MAIN ST
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2122
Practice Address - Country:US
Practice Address - Phone:406-363-2273
Practice Address - Fax:406-363-2709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTD239038-1435560310400000X
MTD239068-1435560314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT=========OtherEIN