Provider Demographics
| NPI: | 1144251885 |
|---|---|
| Name: | CENTER FOR MENTAL HEALTH |
| Entity type: | Organization |
| Organization Name: | CENTER FOR MENTAL HEALTH |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SYDNEY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BLAIR |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 406-781-6852 |
| Mailing Address - Street 1: | PO BOX 3089 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GREAT FALLS |
| Mailing Address - State: | MT |
| Mailing Address - Zip Code: | 59403-3089 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 406-791-9599 |
| Mailing Address - Fax: | 406-791-9629 |
| Practice Address - Street 1: | 915 1ST AVE S |
| Practice Address - Street 2: | |
| Practice Address - City: | GREAT FALLS |
| Practice Address - State: | MT |
| Practice Address - Zip Code: | 59401-3705 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 406-771-8648 |
| Practice Address - Fax: | 406-771-8648 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-07-05 |
| Last Update Date: | 2023-08-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 101YM0800X, 1041C0700X, 207Q00000X, 2084P0800X, 251B00000X, 251S00000X, 261QR0405X, 320800000X, 322D00000X, 363LC1500X, 363LF0000X, 363LP0808X | ||
| MT | 10720 | 261QM0801X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 251B00000X | Agencies | Case Management | ||
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | Group - Multi-Specialty | |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
| No | 363LC1500X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Community Health | Group - Multi-Specialty |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MT | 00396-7 | Other | BLUE CROSS/SHIELD GROUP # |
| MT | 10720 | Other | HEALTH CARE FACILITY LIC |
| MT | 2364 | Other | HEALTH/E/WEB SUBMITTER ID |
| MT | 74961 | Other | BC-BS CENTER4MH ID # |
| MT | 10720 | Other | HEALTH CARE FACILITY LIC |
