Provider Demographics
NPI:1922407048
Name:SMELTER CITY FAMILY DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:SMELTER CITY FAMILY DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FENCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-560-6442
Mailing Address - Street 1:PO BOX 1040
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1040
Mailing Address - Country:US
Mailing Address - Phone:406-560-6442
Mailing Address - Fax:
Practice Address - Street 1:118 E 7TH ST
Practice Address - Street 2:2L
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2900
Practice Address - Country:US
Practice Address - Phone:406-560-6442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891104352OtherNPI