Healthcare Provider Details

I. General information

NPI: 1598049777
Provider Name (Legal Business Name): INTERMOUNTAIN CTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3240 DREDGE DR
HELENA MT
59602-0548
US

IV. Provider business mailing address

3240 DREDGE DR
HELENA MT
59602-0548
US

V. Phone/Fax

Practice location:
  • Phone: 406-442-7920
  • Fax: 406-442-7949
Mailing address:
  • Phone: 406-442-7920
  • Fax: 406-442-7949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER WILLIAMS
Title or Position: CAO
Credential:
Phone: 406-457-4822