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NPI Code Detail

MEDICARE: EASTERN MT COMMUNITY MENTAL HEALTH CDU PROG

MEDICARE: EASTERN MT COMMUNITY MENTAL HEALTH CDU PROG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center273-07MT
2261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912032509
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERN MT COMMUNITY MENTAL HEALTH CDU PROG
Provider Business Mailing Address
First Line : 2508 WILSON ST
Second Line :
City : MILES CITY
State : MT
Zip : 59301-5000
Country : US
Telephone Number : 406-234-0234
Fax Number :
Provider Business Practice Location Address
First Line : 2508 WILSON ST
Second Line :
City : MILES CITY
State : MT
Zip : 59301-5000
Country : US
Telephone Number : 406-234-0234
Fax Number :
Authorized Official
Title or Position : CIO
Name : KATHY BEASON
Credential :
Telephone Number : 406-234-0234
Provider Enumeration Date : 02/22/2007
Last Update Date : 10/23/2024

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Directions to “EASTERN MT COMMUNITY MENTAL HEALTH CDU PROG ” Practice Location

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