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General NPI Number Information
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NPI Number | 1356143929
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Entity Type | Individual
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Provider Name | WILLLIAM RUSSELL HARTFORD CBHPSS
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Gender | Male
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 390 HODGSON RD
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-9063
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Country | US
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Telephone | 406-897-2788
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Fax |
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Provider Business Mailing Address
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Address Line | 133 CARDIFF AVE
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City | KALISPELL
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State | MT
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Zip | 59901-2751
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Country | US
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Telephone | 406-253-0218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | BBH-BHPS-CRT-42888
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License Number State | MT
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