Healthcare Provider Details

I. General information

NPI: 1134868573
Provider Name (Legal Business Name): HEALING ROOTS BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16862 BECKWITH ST STE S
FRENCHTOWN MT
59834-9001
US

IV. Provider business mailing address

PO BOX 725
FRENCHTOWN MT
59834-0725
US

V. Phone/Fax

Practice location:
  • Phone: 406-240-9284
  • Fax:
Mailing address:
  • Phone: 406-240-9284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN HENDERSON
Title or Position: OWNER
Credential:
Phone: 406-240-9284