Healthcare Provider Details

I. General information

NPI: 1205991494
Provider Name (Legal Business Name): COUNTY OF MISSOULA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W ALDER ST
MISSOULA MT
59802-4123
US

IV. Provider business mailing address

301 W ALDER ST
MISSOULA MT
59802-4123
US

V. Phone/Fax

Practice location:
  • Phone: 406-258-4745
  • Fax: 406-258-4913
Mailing address:
  • Phone: 406-258-4750
  • Fax: 406-258-4913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: JEANNA MILLER
Title or Position: HEALTH OFFICER
Credential:
Phone: 406-258-4996