Healthcare Provider Details

I. General information

NPI: 1194862086
Provider Name (Legal Business Name): A.W.A.R.E
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S MONTANA ST
BUTTE MT
59701-2840
US

IV. Provider business mailing address

3250 S DAKOTA ST
BUTTE MT
59701-3116
US

V. Phone/Fax

Practice location:
  • Phone: 406-533-2972
  • Fax:
Mailing address:
  • Phone: 406-565-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. PAT NOONAN
Title or Position: SUPERVISOR
Credential:
Phone: 406-782-2042