NPIMap

Organization Active NPI

Wilderness Alternative School, Inc

  • Substance Abuse Rehabilitation Facility
  • Marion, MT
National Provider Identifier
1144372012
Registry record updated Feb 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
10132 Issued in MT
Legal business name
WILDERNESS ALTERNATIVE SCHOOL, INC
Practice address
200 Hubbart Dam Rd
Marion, MT 59925-9708
Phone
(406) 854-2832
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2012

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

Authorized official

Name
Mr. John E. Brekke, LAC
Title
President
Phone
(406) 854-2832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 10132 MT Primary

Addresses

Primary practice location

200 Hubbart Dam Rd
Marion, MT 59925-9708

Mailing address

200 Hubbart Dam Rd
Marion, MT 59925-9708
Phone (406) 854-2832

Other identifiers 1

IdentifierTypeStateIssuer
02662OtherMTBLUE CROSS BLUE SHIELD

Other names 1

  • Wilderness Treatment Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1144372012",
    "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": "406-854-2832"
        },
        {
            "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": "406-854-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDERNESS ALTERNATIVE SCHOOL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "BREKKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-854-2832",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MT",
            "license": "10132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02662",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilderness Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.