Provider Demographics
NPI:1679904726
Name:TURTLE GAP, INC.
Entity Type:Organization
Organization Name:TURTLE GAP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STOEHR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-363-1217
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:252 WEBER DRIVE
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-0058
Mailing Address - Country:US
Mailing Address - Phone:406-363-1217
Mailing Address - Fax:406-794-0700
Practice Address - Street 1:81 KURTZ LN
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3201
Practice Address - Country:US
Practice Address - Phone:406-363-1217
Practice Address - Fax:406-794-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT74186-0Medicaid