Missoula Urban Indian Health Center, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

224-15 Issued in MT

Legal business name

MISSOULA URBAN INDIAN HEALTH CENTER, INC.

Practice address

830 W Central Ave
Missoula, MT 59801-7931

Phone

(406) 829-9515

Fax

(406) 829-9519

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Leeann Bruised Head, MPH

Title

Executive Director

Phone

(406) 829-9515

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Missoula Indian Center, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Federally qualified health center certification: CCN 271868

Legal name

ALL NATIONS HEALTH CENTER, INC.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Oct 11, 2018

Last certification

Oct 11, 2018

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 1, 1970 in MT

Enrollment address

830 W Central Ave
Missoula, MT 59801-7931

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• All Nations Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
  • NPI 1649663923

  O20181012000401

  Same enrollment

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• All Nations Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Missoula, MT
  • NPI 1649663923

  Operational/Managerial Control

  CMS ownership

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1285769786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017931",
            "telephone_number": "406-829-9515",
            "fax_number": "406-829-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 W CENTRAL AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017931",
            "telephone_number": "406-829-9515",
            "fax_number": "406-829-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA URBAN INDIAN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "BRUISED HEAD",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "406-829-9515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MT",
            "license": "224-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320025",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missoula Indian Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Missoula SNF Operations, LLC
• Missoula Speech Therapy Services, LLC
• Missoula Sports Medicine and Imaging LLC
• Missoula Surgical Associates, PLLC
• Missoula Therapy, PLLC
• Missoula Urban Transportation District
• Missoula Urology PLLC
• Missoula Valley Medical
• Missoula Valley Physical Medicine and Rehabilitation, PLLC
• Missouri Consumer Direct, LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Missoula, MT
• Providers in Missoula, MT by specialty
• 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 Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.