Organization
ALIVE AND WELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL STAMBORSKI LCPC, LAC (THERAPIST)
(406) 892-8830
Entity
Organization
Contact information
Practice address
1611 N FORK RD, COLUMBIA FALLS, MT 59912-9410
(406) 892-8830
Mailing address
1611 N FORK RD, COLUMBIA FALLS, MT 59912-9410
(406) 892-8830
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1103
MT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
1103
MT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
1183
MT
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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