Provider Demographics
NPI:1083974661
Name:PARTNERSHIP HEALTH CENTER INC.
Entity Type:Organization
Organization Name:PARTNERSHIP HEALTH CENTER INC.
Other - Org Name:PHC SEELEY LAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-258-3360
Mailing Address - Street 1:323 W ALDER ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4123
Mailing Address - Country:US
Mailing Address - Phone:406-258-4789
Mailing Address - Fax:406-258-4180
Practice Address - Street 1:3050 HIGHWAY 83 NORTH
Practice Address - Street 2:
Practice Address - City:SEELEY LAKE
Practice Address - State:MT
Practice Address - Zip Code:59868
Practice Address - Country:US
Practice Address - Phone:406-258-4789
Practice Address - Fax:406-258-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1083974661Medicaid
MT011003623Medicare UPIN
MT1083974661Medicaid