Provider Demographics
NPI:1235665845
Name:FRIENDSHIP HOUSE OF CHRISTIAN SERVICE
Entity Type:Organization
Organization Name:FRIENDSHIP HOUSE OF CHRISTIAN SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDGREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-259-5569
Mailing Address - Street 1:3123 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-3939
Mailing Address - Country:US
Mailing Address - Phone:406-259-5569
Mailing Address - Fax:406-259-9117
Practice Address - Street 1:3123 8TH AVE S
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-3939
Practice Address - Country:US
Practice Address - Phone:406-259-5569
Practice Address - Fax:406-259-9117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty