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General NPI Number Information
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NPI Number | 1205165735
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Entity Type | Organization
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Legal Business Name | SAFE HARBOR THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 2475 VILLAGE LN STE 102
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City | BILLINGS
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State | MT
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Zip | 59102-2497
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Country | US
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Telephone | 406-696-2246
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Fax | 406-896-0231
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Provider Business Mailing Address
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Address Line | PO BOX 21292
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City | BILLINGS
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State | MT
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Zip | 59104-1292
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Country | US
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Telephone | 406-696-2246
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Fax | 406-896-0231
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DENNIS WILLIAM MURI
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Credential | LCSW, LAC
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Telephone | 406-696-2246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1130 LAC
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 841-LCSW
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License Number State | MT
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