Healthcare Provider Details

I. General information

NPI: 1417897984
Provider Name (Legal Business Name): FORTY ONE BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 W STORY ST
BOZEMAN MT
59715-4375
US

IV. Provider business mailing address

913 W STORY ST
BOZEMAN MT
59715-4375
US

V. Phone/Fax

Practice location:
  • Phone: 406-312-3487
  • Fax:
Mailing address:
  • Phone: 406-312-3487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEVON SANDERS
Title or Position: OWNER
Credential: LAC
Phone: 406-231-1750