Provider Demographics
NPI:1235870106
Name:COLMAN COMMUNITY SERVICES
Entity Type:Organization
Organization Name:COLMAN COMMUNITY SERVICES
Other - Org Name:COLMAN COMMUNITY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LSWC
Authorized Official - Phone:406-565-6641
Mailing Address - Street 1:1824 N LAST CHANCE GULCH
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0700
Mailing Address - Country:US
Mailing Address - Phone:406-594-6972
Mailing Address - Fax:406-513-1055
Practice Address - Street 1:1824 N LAST CHANCE GULCH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0700
Practice Address - Country:US
Practice Address - Phone:406-594-6972
Practice Address - Fax:406-513-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1457924631Medicaid
1457924631OtherNPI