Organization
HI-LINE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILIAM MARTIN LAC (EXECUTIVE DIRECTOR)
(406) 873-2155
Entity
Organization
Contact information
Practice address
1210 E MAIN ST, CUT BANK, MT 59427-3152
(406) 873-2155
Mailing address
1210 E MAIN ST, CUT BANK, MT 59427-3152
(406) 873-2155
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
01/28/2009
Last updated
01/28/2009
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