Provider Demographics
NPI:1245775691
Name:TRI-COUNTY SPECIAL EDUCATION COOPERATIVE
Entity type:Organization
Organization Name:TRI-COUNTY SPECIAL EDUCATION COOPERATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRICOUNTY COOP DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-436-2488
Mailing Address - Street 1:PO BOX 718
Mailing Address - Street 2:
Mailing Address - City:BROADUS
Mailing Address - State:MT
Mailing Address - Zip Code:59317-0718
Mailing Address - Country:US
Mailing Address - Phone:406-436-2488
Mailing Address - Fax:406-436-2151
Practice Address - Street 1:119 N PARK AVE.
Practice Address - Street 2:
Practice Address - City:BROADUS
Practice Address - State:MT
Practice Address - Zip Code:59317-0718
Practice Address - Country:US
Practice Address - Phone:406-436-2488
Practice Address - Fax:406-436-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT103T0000XMedicaid
MT225X00000XMedicaid
MT2355S0801XMedicaid
MT235Z00000XMedicaid
MT225100000XMedicaid
MT1245775691Medicaid