Provider Demographics
NPI:1184847071
Name:MONTANA COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:MONTANA COMMUNITY SERVICES, INC.
Other - Org Name:MT COMMUNITY SERVICES, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:B
Authorized Official - Last Name:HERZOG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-656-5976
Mailing Address - Street 1:993 S 24TH ST W STE B
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7433
Mailing Address - Country:US
Mailing Address - Phone:406-656-5976
Mailing Address - Fax:406-656-0128
Practice Address - Street 1:993 S 24TH ST W STE B
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7433
Practice Address - Country:US
Practice Address - Phone:406-656-5976
Practice Address - Fax:406-656-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0012617251S00000X
320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0351407Medicaid
MT0620542Medicaid
MT0320178Medicaid