Healthcare Provider Details

I. General information

NPI: 1801437397
Provider Name (Legal Business Name): JOURNEY TO RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2019
Last Update Date: 10/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N. PUBLIC SQUARE
BROWNING MT
59417
US

IV. Provider business mailing address

P.O. BOX 1349 109 N. PUBLIC SQUARE
BROWNING MT
59417
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-3123
  • Fax:
Mailing address:
  • Phone: 406-338-3123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. TIMOTHY DAVIS
Title or Position: CHAIRMAN, BLACKFEET TRIBE
Credential:
Phone: 406-338-7391