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General NPI Number Information
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NPI Number | 1407339401
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Entity Type | Organization
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Legal Business Name | GLACIER HOPE HOMES, INC.
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 07/06/2020
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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 | 406-871-6738
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Fax |
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Provider Business Mailing 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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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JASON ADAM STEVENS
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Credential |
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Telephone | 406-871-6738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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