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General NPI Number Information
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NPI Number | 1932116340
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Entity Type | Organization
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Legal Business Name | STATE OF MONTANA
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 300 GARNET WAY
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City | WARM SPRINGS
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State | MT
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Zip | 59756-0300
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Country | US
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Telephone | 406-693-7021
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Fax | 406-693-7023
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Provider Business Mailing Address
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Address Line | 111 N SANDERS ST DEPT 30
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City | HELENA
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State | MT
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Zip | 59601-4520
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Country | US
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Telephone | 406-444-3416
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Fax | 406-444-3082
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Authorized Official
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Title or Position | FACILITY REIMBURSEMENT MANAGER
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Name | MRS. ALEASHA MARTIN
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Credential |
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Telephone | 406-444-3416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 10419
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License Number State | MT
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