Provider Demographics
NPI:1720382369
Name:WESTERN MONTANA MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:WESTERN MONTANA MENTAL HEALTH CENTER
Other - Org Name:HAYS MORRIS HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-532-8400
Mailing Address - Street 1:140 N RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-1704
Mailing Address - Country:US
Mailing Address - Phone:406-532-8400
Mailing Address - Fax:406-224-4402
Practice Address - Street 1:24 E COPPER ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-9302
Practice Address - Country:US
Practice Address - Phone:406-723-7104
Practice Address - Fax:406-723-4857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11813320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness