Triple Divide Lodge LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

TRIPLE DIVIDE LODGE LLC

Practice address

200 Hubbart Dam Rd
Marion, MT 59925-9708

Phone

(406) 296-4272

Fax

(406) 854-2835

NPI assigned

Sep 22, 2021

Organization subpart

No

Name

Patrick Hawkins, LAC

Title

Executive Director

Phone

(406) 296-4272

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nathaniel A Moore, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Marion, MT
  • NPI 1518565803
  NPD

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 22, 2021.

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1104597939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HUBBART DAM RD",
            "city": "MARION",
            "state": "MT",
            "postal_code": "599259708",
            "telephone_number": "406-296-4272",
            "fax_number": "406-854-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HUBBART DAM RD",
            "city": "MARION",
            "state": "MT",
            "postal_code": "599259708",
            "telephone_number": "406-296-4272",
            "fax_number": "406-854-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPLE DIVIDE LODGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "406-296-4272",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montana Academy, Incorporated
• Nathaniel A Moore, LAC
• Anne E Murphy, LCPC
• John L. Santa, PH.D.
• Melissa Ann Sutton, BSN RN
• Western Montana Works LLC
• Wilderness Alternative School, Inc

• All providers in Marion, MT
• Substance Use Disorder Rehabilitation Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.