NPIMap

Organization Active NPI

Partnership Health Center Inc

Doing business as dba PHC-Big Sky High School- Behavioral Health

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
National Provider Identifier
1174406599
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PARTNERSHIP HEALTH CENTER INC
Doing business as
dba PHC-Big Sky High School- Behavioral Health
Practice address
3100 South Ave W
Missoula, MT 59804-5106
Phone
(406) 258-4789
Fax
(406) 258-4578
NPI assigned
Jul 31, 2025
Last updated
Jul 31, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PARTNERSHIP HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Lara Salazar
Title
Ceo
Phone
(406) 258-3360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3100 South Ave W
Missoula, MT 59804-5106

Mailing address

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4789

Other names 1

  • dba PHC-Big Sky High School- Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250923002149 MT Part A Provider - Federally Qualified Health Center (FQHC) 6103843479 Practice locations: Missoula, MT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174406599. Details of each certification follow.

Federally qualified health center certification: CCN 271023

Legal name
PARTNERSHIP HEALTH CENTER INC
Doing business as
PHC-BIG SKY HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 8, 2025
Last certification
Sep 8, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3100 South Ave W
Missoula, MT 59804-5106

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Partnership Health Ctr18 organizations share this tax ID, including this one
Part of
Partnership Health Ctr

Other organizations with this tax ID 17

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

View all 17

Locations

3100 South Ave W
Missoula, MT 59804
Phone (406) 728-2401

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Walters Individual Corporate DirectorBoard Member Jul 1, 2013 1%
Jay Raines Individual Corporate DirectorBoard Member Jan 1, 2024 1%
Bryan William Chalmers Individual Corporate OfficerCfo Dec 16, 2019 1%
Mark Thane Individual Corporate DirectorBoard Member Oct 1, 2019 1%
Patricia Kero Individual Corporate DirectorBoard Member Nov 1, 2021 1%
Lara Salazar Individual Corporate OfficerCeo Oct 3, 2022 1%
W-2 Managing EmployeeAd; Oct 3, 2022 1%
Suzette Baker Individual Corporate DirectorBoard Member Apr 1, 2024 1%
Esther Tuttle Individual Corporate DirectorBoard Member Dec 1, 2024 1%
Joseph Melvin Individual Corporate DirectorBoard Member Jan 1, 2019 1%
Kristin Petersen Individual Corporate DirectorBoard Member Sep 1, 2024 1%
Andrea Green Individual Corporate DirectorBoard Member Mar 1, 2021 1%
Natalie Wolfram Individual Corporate DirectorBoard Member Oct 1, 2018 1%
John Crawford Individual Corporate DirectorBoard Member Feb 1, 2016 1%
Jilayne Dunn Individual Corporate DirectorBoard Member Dec 1, 2013 1%

NPI Registry JSON

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

{
    "created_epoch": "1753920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1174406599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598045106",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERSHIP HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARTNERSHIP HEALTH CENTER INC",
        "enumeration_date": "2025-07-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "406-258-3360"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba PHC-Big Sky High School- Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.