Provider Demographics
NPI:1033678396
Name:GUIDED HEALING TRAILS LLC
Entity Type:Organization
Organization Name:GUIDED HEALING TRAILS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:SUCHANIC
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LCPC
Authorized Official - Phone:406-540-4120
Mailing Address - Street 1:500 N HIGGINS AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4550
Mailing Address - Country:US
Mailing Address - Phone:406-540-4120
Mailing Address - Fax:406-540-4160
Practice Address - Street 1:913 SW HIGGINS AVE STE 201
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1423
Practice Address - Country:US
Practice Address - Phone:406-540-4120
Practice Address - Fax:406-540-4160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-17
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder