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Organization
EATING DISORDER CENTER OF MONTANA
Active
Organization
EATING DISORDER CENTER OF MONTANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENI RUTH GOCHIN (CLINICAL DIRECTOR)
(805) 637-4900
Entity
Organization
Contact information
Practice address
319 S WILLSON AVE, BOZEMAN, MT 59715-4632
(406) 451-7370
(406) 571-7956
Mailing address
PO BOX 1306, BOZEMAN, MT 59771-1306
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
—
163WG0000X
General Practice Registered Nurse
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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