Organization
DISTRICT II ALCOHOL AND DRUG PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY D SCHLEPP M.A., LAC (EXECUTIVE DIRECTOR)
(406) 377-5942
Entity
Organization
Contact information
Practice address
119 S KENDRICK AVE, GLENDIVE, MT 59330-1626
(406) 377-5942
(406) 377-3050
Mailing address
119 S KENDRICK AVE, GLENDIVE, MT 59330-1626
(406) 377-5942
(406) 377-3050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
211-07
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320042
—
MT
01
—
76361
BCBS PROVIDEER NUMBER
MT
Enumeration date
01/29/2007
Last updated
02/19/2008
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