Provider Demographics
NPI:1922155209
Name:BITTERROOT VALLEY EDUCATION COOPERATIVE
Entity Type:Organization
Organization Name:BITTERROOT VALLEY EDUCATION COOPERATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-777-2494
Mailing Address - Street 1:300 PARK ST
Mailing Address - Street 2:PO BOX 187
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2603
Mailing Address - Country:US
Mailing Address - Phone:406-777-2494
Mailing Address - Fax:496-777-2495
Practice Address - Street 1:300 PARK ST
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2603
Practice Address - Country:US
Practice Address - Phone:406-777-2494
Practice Address - Fax:496-777-2495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT165733Medicaid
MT255663Medicaid
MT350795Medicaid
MT740430OtherMENTAL HEALTH CENTER
MT741140OtherLCPC
MT256598Medicaid
MT743470OtherSOCIAL WORK
MT160498Medicaid
MT165724Medicaid
MT165750Medicaid
MT165784Medicaid
MT165737Medicaid
MT165763Medicaid
MT502486Medicaid
MT165767Medicaid
MT165776Medicaid
MT503489Medicaid
MT71625OtherSOCIAL WORK