Organization
MISSOULA URBAN INDIAN HEALTH CENTER, INC.
Active
Other names
Missoula Indian Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEEANN BRUISED HEAD MPH (EXECUTIVE DIRECTOR)
(406) 829-9515
Entity
Organization
Contact information
Practice address
830 W CENTRAL AVE, MISSOULA, MT 59801-7931
(406) 829-9515
(406) 829-9519
Mailing address
830 W CENTRAL AVE, MISSOULA, MT 59801-7931
(406) 829-9515
(406) 829-9519
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
224-15
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320025
—
MT
Enumeration date
02/23/2007
Last updated
11/18/2015
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