COMMUNITY MEDICAL SERVICES MONTANA-PRIVATE, LLC (NPI# 1659722114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659722114 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL SERVICES MONTANA-PRIVATE, LLC |
| Other Organization Name | COMMUNITY MEDICAL SERVICES |
| Practice Address |
2521 E Mountain Village Dr Ste F Wasilla AK 99654 |
| Mailing Address |
9449 N 90th St Ste 210 Scottsdale AZ 85258-5037 |
| Practice Telephone | 9072903760 |
| Practice Fax Number | 9076310647 |
| Mailing Telephone | 6022488886 |
| Mailing Fax Number | 6022488999 |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | TODD STINGLEY (CFO) |
| Authorized Official Telephone | 6022488886 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1036521 | AK | Behavioral Health & Social Service Providers |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1036521 | AK | Ambulatory Health Care Facilities |
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
1036521 | AK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Community Medical Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420849 | Community Medical Services Montana-private, LLC | Clinic/Center | 109 N Public Sq, Browning, MT 59417-5316 | 2020-02-28 |
| 1205360153 | Community Medical Services Montana-private, LLC | Counselor | 901 28th St S Ste B, Fargo, ND 58103-8743 | 2017-04-18 |
| 1356792816 | Community Medical Services Montana-private, LLC | Counselor | 300 30th Ave Nw Ste D, Minot, ND 58703-0611 | 2016-06-27 |
| 1467828061 | Community Medical Services Montana-private, LLC | Counselor | 2040 Rosebud Dr Ste 7, Billings, MT 59102-6294 | 2015-08-18 |
| 1306247325 | Community Medical Services Montana-private, LLC | Community/Behavioral Health | 1829 S Broadway, Suite 1, Minot, ND 58701-6571 | 2014-09-09 |
| 1679926745 | Community Medical Services Montana-private, LLC | Clinic/Center | 9449 N 90th St, Suite 210, Scottsdale, AZ 85258 | 2016-07-13 |
| 1790132082 | Community Medical Services Montana-private, LLC | Counselor | 8707 Jackrabbit Ln, Belgrade, MT 59714-8995 | 2016-05-17 |
| 1023484615 | Community Medical Services Montana-private, LLC | Counselor | 2415 S Catlin St, Missoula, MT 59801-7822 | 2015-08-18 |
| 1407222003 | Community Medical Services Montana-private, LLC | Counselor | 795 Sunset Blvd Ste F, Kalispell, MT 59901-3699 | 2015-08-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEDICAL SERVICES MONTANA-PRIVATE, LLC | 2040 Rosebud Dr Ste 7, Billings, MT 59101-6294 |
| Colorado Business Entities | Community Medical Services Montana-Private, LLC | 14300 E. Exposition Avenue, Aurora, CO 80012 |
| Street Address |
2521 E MOUNTAIN VILLAGE DR STE F |
| City | WASILLA |
| State | AK |
| Zip Code | 99654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144872151 | Jovan Kidder Aila | Case Manager/Care Coordinator | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-10 |
| 1780246082 | Kara Jane Holbrook | Licensed Practical Nurse | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-08 |
| 1013579317 | Camille Machea Johnson | Registered Nurse | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-08 |
| 1760044077 | Barbara Johnson-tow | Counselor | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-08 |
| 1982266326 | Lacage Marie Henderson | Counselor | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932244712 | Narcotic Drug Treatment Center, Inc. | Clinic/Center | 1015 E 6th Ave, Anchorage, AK 99501-2748 | 2007-02-20 |
| 1063044659 | Narcotic Drug Treatment Center, Inc. | Clinic/Center | 1015 E 6th Ave, Anchorage, AK 99501-2748 | 2020-02-11 |
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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.