Provider Demographics
NPI:1629618566
Name:BAER BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:BAER BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BROOKS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-253-3942
Mailing Address - Street 1:100 S CURTIS ST APT 5
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-1357
Mailing Address - Country:US
Mailing Address - Phone:406-253-3942
Mailing Address - Fax:
Practice Address - Street 1:2875 TINA AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1581
Practice Address - Country:US
Practice Address - Phone:496-252-2942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty