MERCY MANOR LLC
Adult Care Home
Bozeman, Montana
Provider NPI: 1619188810
Organization Information:Organization Name: MERCY MANOR LLC
Practice Location:
5830 SYPES CANYON RD BOZEMAN, MT 59715 US
Tel: 406-556-1868 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
5830 SYPES CANYON RD BOZEMAN, MT 59715 US
Tel: 406-556-1868 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | MT | 0027125001 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0640883 | MT | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin