National Provider Identifier Database

WESTERN MONTANA MENTAL HEALTH CENTER
Mental Health (Including Community Mental Health Center)

Contact Information

WESTERN MONTANA MENTAL HEALTH CENTER
1321 WYOMING ST
MISSOULA, MT  59801-1725
Phone: 406-532-8400
Fax: 406-224-4402
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X
Addiction (Substance Use Disorder) 101YA0400X
Adolescent and Children Mental Health 261QM0855X
Adult Mental Health 261QM0850X
Case Management 251B00000X
Clinical 1041C0700X
Community Based Residential Treatment Facility, Mental Illness 320800000X
Community/Behavioral Health 251S00000X
Physician Assistant 363A00000X
Professional 101YP2500X
Psychiatric Residential Treatment Facility 323P00000X
Psychiatric/Mental Health 363LP0808X
Psychiatry 2084P0800X
Rehabilitation, Substance Use Disorder 261QR0405X
Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for WESTERN MONTANA MENTAL HEALTH CENTER

NPI Number 1912079328
Legal business name
LBN		 WESTERN MONTANA MENTAL HEALTH CENTER
Authorized official CORY DESTEIN - (CHIEF ADMINISTRATIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 11/14/2006
Last updated 05/28/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • MT License #: 11034
  • MT License #: 13459
  • MT License #: 258 07
  • MT Medicaid: 047379
  • MT Medicaid: 141232
  • MT Medicaid: 255425
  • MT Medicaid: 290108
  • MT Medicaid: 320177
  • MT Medicaid: 320385
  • MT Medicaid: 320424
  • MT Medicaid: 352248
  • MT Medicaid: 439161
  • MT Medicaid: 491419
  • MT Medicaid: 502316
  • MT Medicaid: 601647
  • MT Other: 000008376 PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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