Provider Demographics
NPI: | 1801015581 |
---|---|
Name: | FLORENCE CRITTENTON HOME AND SERVICES INC. |
Entity type: | Organization |
Organization Name: | FLORENCE CRITTENTON HOME AND SERVICES INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CARRIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KREPPS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 406-442-6950 |
Mailing Address - Street 1: | 901 NORTH HARRIS |
Mailing Address - Street 2: | |
Mailing Address - City: | HELENA |
Mailing Address - State: | MT |
Mailing Address - Zip Code: | 59601 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-442-6950 |
Mailing Address - Fax: | 406-442-6571 |
Practice Address - Street 1: | 901 NORTH HARRIS |
Practice Address - Street 2: | |
Practice Address - City: | HELENA |
Practice Address - State: | MT |
Practice Address - Zip Code: | 59601 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-442-6950 |
Practice Address - Fax: | 406-442-6571 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-04-24 |
Last Update Date: | 2019-07-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
3245S0500X, 261QM0850X, 261QM0855X, 261QR0405X, 324500000X, 2084P0804X, 101YM0800X, 251B00000X, 1041C0700X, 2084P0800X, 261Q00000X, 261QM0801X, 251S00000X | ||
MT | 0001236-001 | 320800000X |
MT | 320800000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children | Group - Multi-Specialty |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Multi-Specialty |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | Group - Multi-Specialty |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | ||
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MT | 0000320195 | Medicaid |