PROVIDENCE HEALTH & SERVICES MT (NPI# 1619058302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619058302 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES MT |
| Other Organization Name | ST PATRICK HOSPITAL PSYCH |
| Practice Address |
902 N Orange St Missoula MT 59802-2928 |
| Mailing Address |
Po Box 3974 Seattle WA 98124-3974 |
| Practice Telephone | 4065427271 |
| Practice Fax Number | 4063295877 |
| Mailing Telephone | 4065427271 |
| Mailing Fax Number | 4063295877 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2011-06-22 |
| Authorized Official Name | MR. BRUCE L WHITFIELD (CFO ST PATRICK HOSPITAL WMSA REGION) |
| Authorized Official Telephone | 4063295868 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 10606 | MT | Hospital Units |
| Other Name | Type Code |
|---|---|
| St Patrick Hospital Psych | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326483587 | Providence Health & Services Mt | Internal Medicine | 24001 East Mission Ave. Ste 105, Providence Healtlh and Services, Montana, Liberty Lake, WA 99019-0012 | 2013-05-01 |
| 1679865497 | Providence Health & Services Mt | Physician Assistant | 3050 Highway 83 N, Seeley Lake, MT 59868 | 2011-05-12 |
| 1427281203 | Providence Health & Services Mt | Internal Medicine | 500 W Broadway Street, Missoula, MT 59802-4096 | 2009-08-27 |
| 1538394267 | Providence Health & Services Mt | Internal Medicine | 435 S Crystal St Ste 240, Butte, MT 59701-1523 | 2009-05-26 |
| 1871750554 | Providence Health & Services Mt | Internal Medicine | 300 W Mercury Street, Butte, MT 59701-1652 | 2008-05-20 |
| 1518124379 | Providence Health & Services Mt | Internal Medicine | 1102 E Commercial Ave, Anaconda, MT 59711-2718 | 2008-05-20 |
| 1881191948 | Providence Health & Services Mt | Clinic/Center | 900 N Orange St Ste 304, Missoula, MT 59802-2951 | 2018-04-06 |
| 1174074827 | Providence Health & Services Mt | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2016-10-18 |
| 1720477953 | Providence Health & Services Mt | Neurological Surgery | 500 W Broadway St, Missoula, MT 59802-4008 | 2015-01-12 |
| 1215222617 | Providence Health & Services Mt | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2011-06-14 |
| Street Address |
902 N ORANGE ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-2928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003821976 | Brooks William Baer | Counselor | 902 N Orange St, Suite 102, Missoula, MT 59802-2928 | 2006-07-29 |
| 1689804239 | Barbara Ann Jacobson | Nurse Practitioner | 902 N Orange St, Missoula, MT 59802-2928 | 2009-07-16 |
| 1699916429 | Providence Health & Services Mt | Physical Medicine & Rehabilitation | 902 N Orange St, 4th Floor, Missoula, MT 59802-2928 | 2009-03-06 |
| 1336380161 | Providence Health & Services Mt | Internal Medicine | 902 N Orange St, Missoula, MT 59802-2928 | 2009-03-06 |
| 1093830515 | Robert C. Munjal | Psychiatry & Neurology | 902 N Orange St, Suite 206, Missoula, MT 59802-2928 | 2007-03-21 |
| 1407860745 | Providence Surgery Center | Clinic/Center | 902 N Orange St, Missoula, MT 59802-2916 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952531063 | St. Peter's Community Hospital | Psychiatric Unit | 2475 E Broadway St, Helena, MT 59601-4928 | 2009-07-23 |
| 1396752200 | Benefis Hospitals, Inc | Psychiatric Unit | 500 15th Ave S, Great Falls, MT 59405-4324 | 2006-08-02 |
| 1881650737 | Benefis Hospitals, Inc. | Psychiatric Unit | 1101 26th St S, Great Falls, MT 59405-5161 | 2006-04-20 |
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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.