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General NPI Number Information
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NPI Number | 1467605592
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Entity Type | Organization
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Legal Business Name | FB COMMUNITY HEALTH REPRESENTATIVES PROGRAM
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 656 AGENCY MAIN ST
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City | HARLEM
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State | MT
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Zip | 59526
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Country | US
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Telephone | 406-353-2525
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Fax | 406-353-2884
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Provider Business Mailing Address
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Address Line | 656 AGENCY MAIN ST
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City | HARLEM
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State | MT
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Zip | 59526-9455
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Country | US
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Telephone | 406-353-2525
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Fax | 406-353-2884
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Authorized Official
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Title or Position | FBIC TRIBAL HEALTH DIRECTOR
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Name | MR. CRAIG CHANDLER
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Credential |
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Telephone | 406-353-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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