Provider Demographics
NPI:1972652014
Name:SILVER BOW COUNTY DEVELOPMENTAL DISABILITIES COUNCIL, INC.
Entity Type:Organization
Organization Name:SILVER BOW COUNTY DEVELOPMENTAL DISABILITIES COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-723-2070
Mailing Address - Street 1:305 W MERCURY ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1659
Mailing Address - Country:US
Mailing Address - Phone:406-723-2070
Mailing Address - Fax:406-723-5345
Practice Address - Street 1:305 W MERCURY ST
Practice Address - Street 2:SUITE 105
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1659
Practice Address - Country:US
Practice Address - Phone:406-723-2070
Practice Address - Fax:406-723-5345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000690744Medicaid