Provider Demographics
NPI:1942492152
Name:SCHAEFER PSYCHIATRIC SERVICES, PLLP
Entity Type:Organization
Organization Name:SCHAEFER PSYCHIATRIC SERVICES, PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-442-2032
Mailing Address - Street 1:4185 N MONTANA AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7665
Mailing Address - Country:US
Mailing Address - Phone:406-442-2032
Mailing Address - Fax:406-442-2097
Practice Address - Street 1:4185 N MONTANA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-7665
Practice Address - Country:US
Practice Address - Phone:406-442-2032
Practice Address - Fax:406-442-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-11
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTP10628-09 146173261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT34974Medicare UPIN