NPI 1902105620

Youth Homes

Organisation Mental Illness Community Based Residential Treatment Facility Missoula, MT

Practice location

Address: 550 N California St, Missoula, MT 59802-3913
Phone: (406) 721-2704
Fax: (406) 721-0034
Mailing address: PO Box 7616, Missoula, MT 59807-7616

Authorised official

Name: Geoffrey Birnbaum
Title: Executive Director
Phone: (406) 721-2704

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 7001001 (MT)

Other Community Based Residential Treatment Facility, Mental Illness providers in Montana →

Registry record

NPI: 1902105620
Entity type: Organization
NPI issued: 21 Mar 2011
Record last updated: 21 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.