NPIMap

Organization Active NPI

Alcohol & Drug Services of Gallatin County

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bozeman, MT
National Provider Identifier
1053521633
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
201 Issued in MT
Legal business name
ALCOHOL & DRUG SERVICES OF GALLATIN COUNTY
Practice address
2310 N 7TH Ave
Bozeman, MT 59715-2550
Phone
(406) 586-5493
Fax
(406) 587-1238
NPI assigned
May 23, 2007
Last updated
Aug 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shelly Johnson
Title
Director
Phone
(406) 586-5493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 201 MT Primary

Addresses

Primary practice location

2310 N 7TH Ave
Bozeman, MT 59715-2550

Mailing address

2310 N 7TH Ave
Bozeman, MT 59715-2550
Phone (406) 586-5493

Other identifiers 2

IdentifierTypeStateIssuer
64109OtherMTBCBS
0000320073MedicaidMT

National Provider Directory

National Provider Directory
Tax ID family
Alcohol Drug Services of Gallatin County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1053521633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N 7TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152550",
            "telephone_number": "406-586-5493",
            "fax_number": "406-587-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N 7TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152550",
            "telephone_number": "406-586-5493",
            "fax_number": "406-587-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALCOHOL & DRUG SERVICES OF GALLATIN COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "406-586-5493"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MT",
            "license": "201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "64109",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000320073",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.