Healthcare Provider Details

I. General information

NPI: 1376431767
Provider Name (Legal Business Name): FRIENDS OF THE CHILDREN - MONTANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 MICHIGAN AVE
MISSOULA MT
59802-5585
US

IV. Provider business mailing address

400 W BROADWAY ST STE 101116
MISSOULA MT
59802-4136
US

V. Phone/Fax

Practice location:
  • Phone: 406-258-8081
  • Fax:
Mailing address:
  • Phone: 406-258-8081
  • Fax: 406-830-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: BEN DAVIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 406-218-6850