Organization
HI-LINE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MARTIN LAC (EXECUTIVE DIRECTOR)
(406) 262-9299
Entity
Organization
Contact information
Practice address
220 3RD AVE, SUITE 110, HAVRE, MT 59501-3554
(406) 265-1071
Mailing address
220 3RD AVE, SUITE 110, HAVRE, MT 59501-3554
(406) 265-1071
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
259-07
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320535
—
MT
Enumeration date
02/20/2007
Last updated
09/02/2008
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