Provider Demographics
NPI:1497220347
Name:MONTANA QUALITY LIVING, LLC
Entity Type:Organization
Organization Name:MONTANA QUALITY LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-370-3507
Mailing Address - Street 1:401 S ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425-2209
Mailing Address - Country:US
Mailing Address - Phone:406-370-3507
Mailing Address - Fax:
Practice Address - Street 1:205 N WISCONSIN ST
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425-1600
Practice Address - Country:US
Practice Address - Phone:406-370-3507
Practice Address - Fax:406-278-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility