Provider Demographics
NPI:1942857933
Name:EMMAUS COUNSELING SERVICES OF MONTANA LLC
Entity Type:Organization
Organization Name:EMMAUS COUNSELING SERVICES OF MONTANA LLC
Other - Org Name:EMMAUS COUNSELING SERVICE OF MONTANA LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAGNOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-808-0662
Mailing Address - Street 1:2 PTARMIGAN CT
Mailing Address - Street 2:
Mailing Address - City:MONTANA CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59634-9223
Mailing Address - Country:US
Mailing Address - Phone:307-331-2661
Mailing Address - Fax:
Practice Address - Street 1:314 N LAST CHANCE GULCH STE 306
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5012
Practice Address - Country:US
Practice Address - Phone:307-331-2661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty