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Organization

STATE OF MONTANA

Active
Other names
Montana Chemical Dependency Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ALEASHA MARTIN (FACILITY REIMBURSEMENT MANAGER)
(406) 444-3416
Entity
Organization

Contact information

Practice address
525 E MERCURY ST, BUTTE, MT 59701-1911
(406) 496-5407
(406) 496-5437
Mailing address
111 N SANDERS ST DEPT 30, HELENA, MT 59601-4520
(406) 444-3416
(406) 444-3082

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2084P0800X
Psychiatry Physician
2084P0802X
Addiction Psychiatry Physician
324500000X
Substance Abuse Rehabilitation Facility
Primary
10324
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
57-0112
MT
05
57-0362
MT
Enumeration date
08/08/2006
Last updated
02/26/2024
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