NPIMap

Organization Active NPI

State of Montana

  • Substance Abuse Rehabilitation Facility
  • Butte, MT
National Provider Identifier
1497765150
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
10324 Issued in MT
Legal business name
STATE OF MONTANA
Practice address
525 E Mercury St
Butte, MT 59701-1911
Phone
(406) 496-5407
Fax
(406) 496-5437
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Mrs. Aleasha Martin
Title
Facility Reimbursement Manager
Phone
(406) 444-3416

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X
Substance Abuse Rehabilitation Facility 324500000X 10324 MT Primary

Addresses

Primary practice location

525 E Mercury St
Butte, MT 59701-1911

Mailing address

111 N Sanders St Dept 30
Helena, MT 59601-4520
Phone (406) 444-3416

Other identifiers 2

IdentifierTypeStateIssuer
57-0112MedicaidMT
57-0362MedicaidMT

Other names 1

  • Montana Chemical Dependency Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000579 MT Part B Supplier - Clinic/Group Practice 3870499676 Receives reassigned benefits from 34 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boulder, MT; Butte, MT; Columbia Falls, MT; Lewistown, MT; Warm Springs, MT

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D2190317Montana Chemical Dependency Center525 East Mercury Street, Butte, MT 59701Certificate of waiverAug 11, 2026

National Provider Directory

National Provider Directory
Tax ID family
John D Moore MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

525 E Mercury St
Butte, MT 59701
Phone (406) 496-5400

2500 Continental Dr
Butte, MT 59701
Phone (406) 496-5400

1130 E Front St
Butte, MT 59701
Phone (406) 491-1313

111 N Sanders St
Rm 105
Helena, MT 59601

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1497765150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N SANDERS ST DEPT 30",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014520",
            "telephone_number": "406-444-3416",
            "fax_number": "406-444-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E MERCURY ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011911",
            "telephone_number": "406-496-5407",
            "fax_number": "406-496-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MONTANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ALEASHA",
        "authorized_official_title_or_position": "FACILITY REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "406-444-3416",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MT",
            "license": "10324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57-0112",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57-0362",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montana Chemical Dependency Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Butte, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.