Provider Demographics
NPI:1841507829
Name:FALLS FAMILY PASTORAL COUNSELING CENTER
Entity type:Organization
Organization Name:FALLS FAMILY PASTORAL COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:406-205-4415
Mailing Address - Street 1:PO BOX 1502
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-1502
Mailing Address - Country:US
Mailing Address - Phone:406-205-4415
Mailing Address - Fax:406-866-0196
Practice Address - Street 1:10 SANDRA LN
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-8209
Practice Address - Country:US
Practice Address - Phone:406-205-4415
Practice Address - Fax:406-866-0196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-11
Last Update Date:2010-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health