Organization
EXTRAORDINARY DISTANCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA H. DURHAM CBHPSS (PRINCIPAL)
(406) 443-2455
Entity
Organization
Contact information
Practice address
178 W LYNDALE AVE, HELENA, MT 59601-2822
(406) 443-2455
Mailing address
178 W LYNDALE AVE, HELENA, MT 59601-2822
(406) 443-2455
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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