- Enrollment id
- O20171011003608
- Enrollment state
- MT
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1649789314
- Multiple npi flag
- N
- Ccn
- 275124
- Associate id
- 6709151020
- Organization name
- SWEETWATER DILLON OPCO, LLC
- Doing business as name
- PIONEER CARE AND REHABILITATION
- Incorporation date
- 2017-09-19
- Incorporation state
- MT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PIONEER CARE AND REHABILITATION
- Affiliation entity name
- SWEETWATER CARE
- Affiliation entity id
- 500
- Address line 1
- 200 N OREGON ST
- City
- DILLON
- State
- MT
- Zip code
- 597253624