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Organization

L ESPRIT PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHANTELLE PLAUCHE (ADMINISTRATOR)
(406) 223-3621
Entity
Organization

Contact information

Practice address
120 S MAIN ST, LIVINGSTON, MT 59047-2624
(406) 223-3621
Mailing address
111 N 3RD ST STE 1, LIVINGSTON, MT 59047-2645
(406) 223-3621

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2084P0804X
Child & Adolescent Psychiatry Physician
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
13496
MT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
320800000X
Mental Illness Community Based Residential Treatment Facility
13496
MT
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1194107003
MT
05
7176890
MT
Enumeration date
06/27/2015
Last updated
12/20/2024
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