Healthcare Provider Details

I. General information

NPI: 1982917167
Provider Name (Legal Business Name): ALEPH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 CEDAR ST
MISSOULA MT
59802-3911
US

IV. Provider business mailing address

2120 S RESERVE ST
MISSOULA MT
59801-6451
US

V. Phone/Fax

Practice location:
  • Phone: 406-721-2537
  • Fax: 406-728-5358
Mailing address:
  • Phone: 406-721-2537
  • Fax: 406-728-5358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1286
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN8886
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number240
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number328
License Number StateMT
# 5
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number76552
License Number StateMT

VIII. Authorized Official

Name: DONNA KAY JENNINGS
Title or Position: OWNER
Credential: APRN
Phone: 406-721-2537