Healthcare Provider Details

I. General information

NPI: 1457637258
Provider Name (Legal Business Name): KEH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 1ST AVE E SUITE 17
KALISPELL MT
59901-4978
US

IV. Provider business mailing address

307 1ST AVE E SUITE 17
KALISPELL MT
59901-4978
US

V. Phone/Fax

Practice location:
  • Phone: 406-752-2523
  • Fax:
Mailing address:
  • Phone: 406-752-2523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number147
License Number StateMT

VIII. Authorized Official

Name: KATHLEEN HAYDEN
Title or Position: PRESIDENT KEH INC
Credential:
Phone: 406-752-2523