Provider Demographics
NPI:1548206642
Name:DOUGLAS CARE CENTER, LLC
Entity Type:Organization
Organization Name:DOUGLAS CARE CENTER, LLC
Other - Org Name:ABERDEEN CARE CENTER, LLC DBA DOUGLAS CARE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-655-1883
Mailing Address - Street 1:2850 OVERLAND AVE.
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102
Mailing Address - Country:US
Mailing Address - Phone:406-655-1883
Mailing Address - Fax:406-655-4626
Practice Address - Street 1:1108 BIRCH
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633
Practice Address - Country:US
Practice Address - Phone:307-358-3397
Practice Address - Fax:307-358-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility