Organization
TRIPLE DIVIDE LODGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK HAWKINS LAC (EXECUTIVE DIRECTOR)
(406) 296-4272
Entity
Organization
Contact information
Practice address
200 HUBBART DAM RD, MARION, MT 59925-9708
(406) 296-4272
(406) 854-2835
Mailing address
200 HUBBART DAM RD, MARION, MT 59925-9708
(406) 296-4272
(406) 854-2835
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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