Provider Demographics
NPI:1669550430
Name:HAVRE DAY ACTIVITY CENTER, INC
Entity type:Organization
Organization Name:HAVRE DAY ACTIVITY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOESPFLUG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-265-5506
Mailing Address - Street 1:235 1ST ST W
Mailing Address - Street 2:P.O. BOX 1847
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3407
Mailing Address - Country:US
Mailing Address - Phone:406-265-5506
Mailing Address - Fax:406-265-5506
Practice Address - Street 1:235 1ST ST W
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3407
Practice Address - Country:US
Practice Address - Phone:406-265-5506
Practice Address - Fax:406-265-5506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services