Organization
SOUTHWEST CHEMICAL DEPENDENCY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN E. MCCAULEY L.A.C. (PROGRAM DIRECTOR)
(406) 222-2812
Entity
Organization
Contact information
Practice address
430 E PARK ST, LIVINGSTON, MT 59047-2755
(406) 222-2812
(406) 222-4764
Mailing address
PO BOX 1587, LIVINGSTON, MT 59047-5587
(406) 222-2812
(406) 222-4764
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
089288
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320076
—
MT
01
—
760140
PROVIDER NUMBER
MT
Enumeration date
03/07/2007
Last updated
09/20/2016
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