Healthcare Provider Details
I. General information
NPI: 1902065006
Provider Name (Legal Business Name): A PLACE FOR RECOVERY, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2008
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
217 W MAIN ST
LAUREL MT
59044-3108
US
IV. Provider business mailing address
217 W MAIN ST
LAUREL MT
59044-3108
US
V. Phone/Fax
- Phone: 406-628-4266
- Fax: 406-628-4267
- Phone: 406-628-4266
- Fax: 406-628-4267
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | 1228 |
| License Number State | MT |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
AMBER
B
MURPHY
Title or Position: LICENSED ADDICTIONS COUNSELOR
Credential: L.A.C.
Phone: 406-628-4266