Organization
EXCELSIOR CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GIBBONS (OWNER)
(406) 926-1322
Entity
Organization
Contact information
Practice address
415 N HIGGINS AVE STE 26, MISSOULA, MT 59802-4560
(406) 926-1322
Mailing address
PO BOX 7145, MISSOULA, MT 59807-7145
(406) 926-1322
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/11/2017
Last updated
10/11/2017
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