Alcohol & Drug Services
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Bozeman, MT
NPI 1922342146 · NPPES record last updated Nov 15, 2012
Key facts
- NPI
- 1922342146
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- License
- 201-13 (MT)
- Legal business name
- ALCOHOL & DRUG SERVICES
- Practice address
- 2310 N 7TH Ave
Bozeman, MT 59715-2550 - Phone
- (406) 586-5493
- Fax
- (406) 587-1238
- NPI assigned
- Nov 15, 2012
- Organization subpart
- No
Authorized official
- Name
- Shelly A. Johnson
- Title
- Director
- Phone
- (406) 856-5493
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Alcohol Drug Services of Gallatin County
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | 201-13 | MT | Yes |
Addresses
Primary practice location
2310 N 7TH Ave
Bozeman, MT 59715-2550
Mailing address
2310 N 7TH Ave
Bozeman, MT 59715-2550
Phone (406) 586-5493
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77039 | Medicaid | MT |
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All providers in Bozeman, MT · Substance Use Disorder Rehabilitation Clinic/Center in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.