| Organization Name: | SHADY LANE ASSISTED LIVING INC |
| NPI Number: | 1770646440 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEE ANN KRUGER (ADMINISTRATOR, SEC,TREAS, RN) |
| Mailing Address: | 1018 Pleasant St Miles City |
| State: | MT US |
| Postal Code: | 593013415 |
| Phone Number: | 4062344104 |
| Fax Number: | 4062348019 |
| NPI Enumeration Date: | 12/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | 10713 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |