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General NPI Number Information
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NPI Number | 1861729535
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Entity Type | Organization
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Legal Business Name | 3 RIVERS MENTAL HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1620 REGENT ST STE A
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City | MISSOULA
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State | MT
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Zip | 59801-5665
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Country | US
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Telephone | 406-830-3294
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 REGENT ST STE A
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City | MISSOULA
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State | MT
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Zip | 59801-5665
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Country | US
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Telephone | 406-830-3294
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Fax | 406-258-0367
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Authorized Official
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Title or Position | MANAGER
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Name | TAE HARTLESS
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Credential |
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Telephone | 406-830-3294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 12127
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12754
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License Number State | MT
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