Provider Demographics
NPI:1003086950
Name:BLUE DIAMOND PSYCHIATRIC SERVICES, PC
Entity Type:Organization
Organization Name:BLUE DIAMOND PSYCHIATRIC SERVICES, PC
Other - Org Name:MONICA GRABRIAN MS, APRN
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, APRN, PMHCNS-BC
Authorized Official - Phone:406-438-6958
Mailing Address - Street 1:PO BOX 1685
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-1685
Mailing Address - Country:US
Mailing Address - Phone:406-438-6958
Mailing Address - Fax:406-422-5624
Practice Address - Street 1:432 N LAST CHANCE GULCH
Practice Address - Street 2:SUITE G
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5014
Practice Address - Country:US
Practice Address - Phone:406-438-6958
Practice Address - Fax:406-422-5624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47511261QM0850X
MTAPN39336261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1629135256OtherNPI NUMBER (INDIVIDUAL)
CO1629135256OtherNPI NUMBER (INDIVIDUAL)
CO1629135256OtherNPI NUMBER (INDIVIDUAL)
MK0313003OtherDEA REGISTRATION NUMBER
COC511968Medicare UPIN