Healthcare Provider Details

I. General information

NPI: 1326466202
Provider Name (Legal Business Name): MONTANA COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 S 24TH ST W STE B
BILLINGS MT
59102-7433
US

IV. Provider business mailing address

993 S 24TH ST W STE B
BILLINGS MT
59102-7433
US

V. Phone/Fax

Practice location:
  • Phone: 406-656-5976
  • Fax: 406-656-0128
Mailing address:
  • Phone:
  • Fax: 406-656-0128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number12617-05
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number12617-06
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number12617-07
License Number StateMT

VIII. Authorized Official

Name: SANDIE SULLINS
Title or Position: SUPPORT SERVICES DIRECTOR
Credential:
Phone: 406-656-5976