FLATHEAD VALLEY CHEMICAL DEPENDENCY CLINIC INC (NPI# 1225106842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225106842 |
| Entity Type | Organization |
| Organization Name | FLATHEAD VALLEY CHEMICAL DEPENDENCY CLINIC INC |
| Practice Address |
1312 N Meridian Rd Kalispell MT 59904-0115 |
| Mailing Address |
Po Box 7115 Kalispell MT 59904-0115 |
| Practice Telephone | 4067566453 |
| Practice Fax Number | 4067568546 |
| Mailing Telephone | 4067566453 |
| Mailing Fax Number | 4067568546 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-06-09 |
| Authorized Official Name | MICHAEL CUMMINS (EXECTIVE DIRECTOR) |
| Authorized Official Telephone | 4067566453 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BLUE CROSS BLUE SHIELD | 0000076391 | 01 |
| MT | 0320372 | 05 |
| Street Address |
1312 N MERIDIAN RD |
| City | KALISPELL |
| State | MT |
| Zip Code | 59904-0115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718689 | County of Flathead | Clinic/Center | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2019-09-10 |
| 1871153817 | Gateway Community Services | Community/Behavioral Health | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2019-06-20 |
| 1457815359 | Cheyenne White | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2019-01-24 |
| 1689161697 | Jennie Eileen Bondurant | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2018-04-16 |
| 1396246609 | Diana L Dusek | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2018-02-22 |
| 1508261066 | Leah Hodous | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2014-10-27 |
| 1356760557 | Sonya K Vanbemmel | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2014-04-15 |
| 1356766380 | Tyler Hensleigh | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2014-02-27 |
| 1487095097 | Lana J Pettit | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2013-07-11 |
| 1336419357 | Elise M Stimpfling | Counselor | 1312 N Meridian Rd, Kalispell, MT 59901-3095 | 2012-01-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386775971 | Derek Dalton | Counselor | 1312 North Meridian, Kalispell, MT 59904-0115 | 2007-03-08 |
| 1225169824 | Delcy Brisbo | Counselor | 1312 North Meridian, Kalispell, MT 59904-0115 | 2007-03-08 |
| 1467522615 | Lottie Lucille Block | Nurse Practitioner | 1075 North Meridian, Kalispell, MT 59904-3699 | 2006-11-08 |
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1942714902 | Patricia Flynn, Lac | Clinic/Center | 1629 Avenue D Ste B4, Billings, MT 59102-3071 | 2017-11-28 |
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| 1386948453 | Misfits, LLC | Clinic/Center | 1111 14th St S Ste C, Great Falls, MT 59405-4656 | 2011-01-04 |
| 1487818928 | New Frontier Addiction Services, Inc. | Clinic/Center | 118 E 7th St Ste 2e, Anaconda, MT 59711-2953 | 2008-07-14 |
| 1053521633 | Alcohol & Drug Services of Gallatin County | Clinic/Center | 2310 N 7th Ave, Bozeman, MT 59715-2550 | 2007-05-23 |
| 1285769786 | Missoula Urban Indian Health Center, Inc. | Clinic/Center | 830 W Central Ave, Missoula, MT 59801-7931 | 2007-02-23 |
| 1629114624 | Chouteau County | Clinic/Center | 1308 Franklin Street, Fort Benton, MT 59442-0459 | 2007-01-29 |
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| 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.