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General NPI Number Information
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NPI Number | 1811536105
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Entity Type | Organization
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Legal Business Name | RISING PEAK ACADEMY
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 2347 MIDDLE RD
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-9236
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Country | US
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Telephone | 406-897-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 2347 MIDDLE RD
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-9236
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Country | US
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Telephone | 406-897-8900
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MATT BREKKE
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Credential |
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Telephone | 406-897-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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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 | 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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