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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