Organization
WESTERN MONTANA MENTAL HEALTH CENTER
Active
Organization
WESTERN MONTANA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLEY MICHELLE PETERSEN N.P. (PSYCHIATRIC NURSE PRACTITIONER)
(406) 532-9700
Entity
Organization
Contact information
Practice address
1315 WYOMING ST, MISSOULA, MT 59801-1725
(406) 432-9700
(406) 541-3035
Mailing address
1315 WYOMING STREET, MISSOULA, MT 59801
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
25102
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508000878
NPI
MT
Enumeration date
03/25/2014
Last updated
03/25/2014
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