Healthcare Provider Details

I. General information

NPI: 1386226132
Provider Name (Legal Business Name): ZENITH TRAILS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W PARK ST STE 211
BUTTE MT
59701-1714
US

IV. Provider business mailing address

PO BOX 654
PHILIPSBURG MT
59858-0654
US

V. Phone/Fax

Practice location:
  • Phone: 406-310-6539
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROMNEE VUSHON
Title or Position: PRESIDENT
Credential:
Phone: 406-310-6539