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General NPI Number Information
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NPI Number | 1801437397
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Entity Type | Organization
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Legal Business Name | JOURNEY TO RECOVERY CENTER
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Dates
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Enumeration Date | 10/05/2019
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Last Update Date | 10/05/2019
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Provider Practice Location Address
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Address Line | 109 N. PUBLIC SQUARE
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City | BROWNING
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State | MT
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Zip | 59417
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Country | US
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Telephone | 406-338-3123
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1349 109 N. PUBLIC SQUARE
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City | BROWNING
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State | MT
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Zip | 59417
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Country | US
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Telephone | 406-338-3123
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN, BLACKFEET TRIBE
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Name | MR. TIMOTHY DAVIS
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Credential |
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Telephone | 406-338-7391
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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 |
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License Number State |
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