Organization
FLATHEAD VALLEY CHEMICAL DEPENDENCY CLINIC INC
Active
Organization
FLATHEAD VALLEY CHEMICAL DEPENDENCY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CUMMINS MA (EXECTIVE DIRECTOR)
(406) 756-6453
Entity
Organization
Contact information
Practice address
1312 N MERIDIAN RD, KALISPELL, MT 59904-0115
(406) 756-6453
(406) 756-8546
Mailing address
PO BOX 7115, KALISPELL, MT 59904-0115
(406) 756-6453
(406) 756-8546
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000076391
BLUE CROSS BLUE SHIELD
MT
05
—
0320372
—
MT
Enumeration date
12/01/2006
Last updated
06/09/2011
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