Healthcare Provider Details

I. General information

NPI: 1497260921
Provider Name (Legal Business Name): INSTAR COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 N LAST CHANCE GULCH
HELENA MT
59601-0700
US

IV. Provider business mailing address

PO BOX 1811
EAST HELENA MT
59635-1811
US

V. Phone/Fax

Practice location:
  • Phone: 406-431-1232
  • Fax: 406-431-1232
Mailing address:
  • Phone: 406-431-1232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1231
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number554
License Number StateMT
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number554
License Number StateMT

VIII. Authorized Official

Name: MS. TERRI R RUSSELL
Title or Position: OWNER
Credential:
Phone: 406-431-1232