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General NPI Number Information
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NPI Number | 1528587581
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Entity Type | Organization
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Legal Business Name | MISSOULA AIDS FUND, INC.
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1500 W. BROADWAY SUITE A
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City | MISSOULA
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State | MT
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Zip | 59802
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Country | US
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Telephone | 406-543-4770
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 W BROADWAY ST STE A
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City | MISSOULA
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State | MT
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Zip | 59808-2007
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Country | US
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Telephone | 406-543-4770
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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 | CHRISTA WEATHERS
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Credential |
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Telephone | 406-543-4770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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