Provider Demographics
NPI:1821126004
Name:RIMROCK FOUNDATION
Entity Type:Organization
Organization Name:RIMROCK FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LENETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-248-3175
Mailing Address - Street 1:PO BOX 30374
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-0374
Mailing Address - Country:US
Mailing Address - Phone:406-248-3175
Mailing Address - Fax:406-248-3821
Practice Address - Street 1:1231 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0122
Practice Address - Country:US
Practice Address - Phone:406-248-3175
Practice Address - Fax:406-248-3821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13319101YP2500X, 104100000X, 1041C0700X, 106H00000X, 251E00000X, 251S00000X
MT10687261QR0405X
MT13317363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0350659Medicaid
MT0320151Medicaid