Provider Demographics
NPI:1205967007
Name:ANDROES & ANDROES
Entity type:Organization
Organization Name:ANDROES & ANDROES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDROES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-3413
Mailing Address - Street 1:PO BOX 3277
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-3277
Mailing Address - Country:US
Mailing Address - Phone:406-752-3413
Mailing Address - Fax:406-752-7062
Practice Address - Street 1:465 LEISURE DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-7587
Practice Address - Country:US
Practice Address - Phone:406-752-3413
Practice Address - Fax:406-752-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT008385364SP0809X
MT34103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000080648Medicare ID - Type Unspecified