Provider Demographics
NPI:1407494115
Name:HEALING MOUNTAIN MENTAL HEALTH
Entity Type:Organization
Organization Name:HEALING MOUNTAIN MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:N
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-370-3283
Mailing Address - Street 1:706 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-5720
Mailing Address - Country:US
Mailing Address - Phone:406-370-3283
Mailing Address - Fax:406-302-5191
Practice Address - Street 1:706 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5720
Practice Address - Country:US
Practice Address - Phone:406-370-3283
Practice Address - Fax:406-302-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)