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Contact Information

JIM C MARTINEZ, LAC
4880 US HIGHWAY 93 S
KALISPELL, MT59901-7985
 Phone: 406-857-2506
 Fax: 406-857-2503
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

NPI Profile & details for

NPI Number 1740552272
Entity Organization
Organization subpart 1 Not specified
Enumeration date 01/30/2012
Last updated 01/30/2012 - About 14 years ago
Identifiers
MT License # 998
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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