WESTERN MONTANA MENTAL HEALTH CENTER; NPI #1912079328

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	Specialty Code	Provider Type
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Addiction (Substance Use Disorder)	101YA0400X
Adolescent and Children Mental Health	261QM0855X
Adult Mental Health	261QM0850X
Case Management	251B00000X
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Community Based Residential Treatment Facility, Mental Illness	320800000X
Community/Behavioral Health	251S00000X
Physician Assistant	363A00000X	97	Physician Assistant
Professional	101YP2500X
Psychiatric Residential Treatment Facility	323P00000X
Psychiatric/Mental Health	363LP0808X	50	Nurse Practitioner
Psychiatry	2084P0800X	26	Physician/Psychiatry
Rehabilitation, Substance Use Disorder	261QR0405X
Substance Abuse Disorder Rehabilitation Facility	324500000X

Indicates primary specialty

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NPI Profile & details for WESTERN MONTANA MENTAL HEALTH CENTER

NPI # 1912079328

LBN Legal business name WESTERN MONTANA MENTAL HEALTH CENTER

Authorized official CORY DESTEIN - (CHIEF ADMINISTRATIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/14/2006

Last updated 05/28/2024 - About 2 years ago

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 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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WESTERN MONTANA MENTAL HEALTH CENTER

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NPI Profile & details for WESTERN MONTANA MENTAL HEALTH CENTER

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