WESTERN MONTANA MENTAL HEALTH CENTER


Address: 7 13th Ave East, Polson, MT 59860
Phone: 4065328400

WESTERN MONTANA MENTAL HEALTH CENTER (NPI# 1306202163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306202163
Entity Type Organization
Organization Name WESTERN MONTANA MENTAL HEALTH CENTER
Other Organization Name LAKE HOUSE
Practice Address 7 13th Ave East
Polson
MT 59860
Mailing Address 140 N Russell St
Missoula
MT 59801-1704
Practice Telephone 4065328400
Practice Fax Number 4065439316
Mailing Telephone 4065328400
Mailing Fax Number 4062244402
Enumeration Date 2016-01-11
Last Update Date 2018-01-25
Authorized Official Name JODI DALY (CEO)
Authorized Official Telephone 4065328400
Authorized Official Credential PHD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness 12652 MT Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Lake House Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1316337264 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 45 East 16th Street, Helena, MT 59601 2015-01-30
1881973816 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 1273 Dakota St, Missoula, MT 59801-1709 2011-08-09
1518246552 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 412 Windward Way, Kalispell, MT 59901-2680 2011-08-09
1528363793 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 1404 Westwood Dr, Hamilton, MT 59840-2315 2011-01-20
1720382369 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 24 E Copper St, Butte, MT 59701-9302 2010-12-22
1689976771 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 701 Farmhouse Ln, Bozeman, MT 59715-9419 2010-11-23
1912079328 Western Montana Mental Health Center Community/Behavioral Health 1321 Wyoming St, Missoula, MT 59801-1725 2006-11-14
1437529021 Western Montana Mental Health Center Substance Abuse Rehabilitation Facility 1321 Wyoming St, Missoula, MT 59801-1725 2015-09-25
1548659113 Western Montana Mental Health Center Internal Medicine 1201 Wyoming St, Missoula, MT 59801-1727 2015-01-20
1164849345 Western Montana Mental Health Center Community/Behavioral Health 1315 Wyoming St, Missoula, MT 59801-1725 2014-03-25

Office Location

Street Address 7 13TH AVE EAST
City POLSON
State MT
Zip Code 59860

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679095020 Ashley J Gilham Registered Nurse #5 4th Ave E., Polson, MT 59860 2017-07-07
1225585532 St. Luke Community Hospital Clinic/Center 107 Ridgewater Dr., Polson, MT 59860 2016-09-02
1154730364 Wanda L King Dietitian, Registered 6 Thirteenth Avenue East, Poslon, MT 59860 2014-08-13
1104255637 Dacia Lee Antiste-fisher Counselor #5 4th Ave. E., Polson, MT 59860 2013-11-05
1154758134 Richard Pierre Pharmacy Technician 5 4th Ave E., Polson, MT 59860 2013-10-04
1154755197 Wal-mart Stores, Inc Durable Medical Equipment & Medical Supplies 36318 Memory Lane, Polson, MT 59860 2013-08-27
1245582022 Catherine D Addison Registered Nurse 5 4th Ave. East, Polson, MT 59860 2012-10-04
1114220787 Erika Ann Weber Social Worker #5 4th Ave. E, Polson, MT 59860 2010-12-21
1942431473 Lisa L. Scalpane Counselor 803 Main Street, Suite C, Polson, MT 59860 2009-07-31
1477727956 Bernadette N. Corum Family Medicine #5 4th Ave. East, Polson, MT 59860 2008-04-16
Find all providers in zip 59860

Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1710450044 Center for Mental Health Community Based Residential Treatment Facility, Mental Illness 626 Central Ave W, Great Falls, MT 59404-2851 2019-01-09
1215488325 Ranch for Kids Project, Inc. Community Based Residential Treatment Facility, Mental Illness 144 Gateway Street, Rexford, MT 59930 2016-10-24
1811357767 New Horizon's Youth Ranch Community Based Residential Treatment Facility, Mental Illness 6442 W Kootenai Rd, Rexford, MT 59930-9440 2016-03-03
1124499660 Gateway Freedom Ranch Community Based Residential Treatment Facility, Mental Illness 111 Glen Lake Dr, Eureka, MT 59917-9680 2015-10-09
1316337264 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 45 East 16th Street, Helena, MT 59601 2015-01-30
1568887404 Selkirk Outdoor Leadership & Education (sole), Inc Community Based Residential Treatment Facility, Mental Illness 121 Wisconsin Ave Ste 101, Whitefish, MT 59937-2304 2014-03-02
1760734149 Rae Ann Moxley Community Based Residential Treatment Facility, Mental Illness 459 Conifer Rd, Libby, MT 59923-2966 2012-10-09
1881973816 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 1273 Dakota St, Missoula, MT 59801-1709 2011-08-09
1518246552 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 412 Windward Way, Kalispell, MT 59901-2680 2011-08-09
1528363793 Western Montana Mental Health Center Community Based Residential Treatment Facility, Mental Illness 1404 Westwood Dr, Hamilton, MT 59840-2315 2011-01-20
Find all providers with the same taxonomy

Competitor

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City POLSON
Zip Code 59860

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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