Healthcare Provider Details

I. General information

NPI: 1396165841
Provider Name (Legal Business Name): RIMROCK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 N 29TH ST
BILLINGS MT
59101-0122
US

IV. Provider business mailing address

1231 N 29TH ST
BILLINGS MT
59101-0122
US

V. Phone/Fax

Practice location:
  • Phone: 406-248-3175
  • Fax:
Mailing address:
  • Phone: 406-248-3175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3345
License Number StateMT

VIII. Authorized Official

Name: JASON D HAKERT
Title or Position: COUNSELOR
Credential: LAC
Phone: 406-248-3175