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Organization

PROVIDENCE HEALTH & SERVICES MT

Active
Parent organization
PROVIDENCE HEALTH & SERVICES MT
Other names
PMT MT Urgent Mental Health, PROVIDENCE MEDICAL GROUP MONTANA
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES MT
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization

Contact information

Practice address
900 N ORANGE ST, STE 102, MISSOULA, MT 59802-2951
(406) 327-3029
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17652
MT

Other

Enumeration date
02/22/2008
Last updated
05/07/2025
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