Organization
CCCS SMART PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENI LEIGH NICHOLS (LICENSED ADDICTION COUNSELOR)
(406) 299-3448
Entity
Organization
Contact information
Practice address
630 W MERCURY ST, BUTTE, MT 59701-1510
(406) 299-3448
(406) 299-3450
Mailing address
630 W MERCURY ST, BUTTE, MT 59701-1510
(406) 299-3448
(406) 299-3450
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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