Organization
DBA PHC RUSSELL ELEMENTARY
Active
Other names
PHC Russell Elementary
Organization subpart
No
Provider details
NPI number
Authorized official
LARA SALAZAR (BILLING MANAGER)
(406) 258-3360
Entity
Organization
Contact information
Practice address
3216 S RUSSELL ST, MISSOULA, MT 59801-8537
(406) 370-0487
(406) 258-4732
Mailing address
401 RAILROAD ST W, MISSOULA, MT 59802-4178
(406) 258-4496
(406) 258-4578
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
08/20/2024
Last updated
02/21/2025
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