Organization
INNER ROADS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELLE SHULMAN (EXECUTIVE DIRECTOR)
(585) 330-0780
Entity
Organization
Contact information
Practice address
734 S 1ST ST W, MISSOULA, MT 59801-1844
(585) 330-0780
Mailing address
734 S 1ST ST W, MISSOULA, MT 59801-1844
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7222705
—
MT
Enumeration date
02/26/2019
Last updated
07/06/2020
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