Organization
GLACIER CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD KINGERY LAC LCPC (DIRECTOR OF COUNSELING)
(406) 794-9515
Entity
Organization
Contact information
Practice address
99 MILLS SPRING RD STE 1, EUREKA, MT 59917
(406) 794-9515
Mailing address
505 2ND ST E, KALISPELL, MT 59901-4515
(406) 794-9515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/18/2018
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