Provider Demographics
NPI:1003243064
Name:MONTANA TELEPSYCH SOLUTIONS INC.
Entity Type:Organization
Organization Name:MONTANA TELEPSYCH SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BOESE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN
Authorized Official - Phone:406-442-2032
Mailing Address - Street 1:4185 N MONTANA AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7665
Mailing Address - Country:US
Mailing Address - Phone:406-442-2032
Mailing Address - Fax:406-442-2097
Practice Address - Street 1:4185 N MONTANA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-7665
Practice Address - Country:US
Practice Address - Phone:406-442-2032
Practice Address - Fax:406-442-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-27589363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1346410701Medicaid
MT1346410701Medicaid