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Organization

MASC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MICHELLE S MCCRACKEN CPC-A, COC-A, BHPSS (BUSINESS MANAGER)
(406) 304-6782
Entity
Organization

Contact information

Practice address
491 SHAW GULCH LANE, SUPERIOR, MT 59872-0214
(406) 304-6371
Mailing address
PO BOX 124, SUPERIOR, MT 59872-0124
(406) 304-6782

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
02/25/2020
Last updated
02/26/2020
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