| King Family Behavioral Health | |
|
839 Rollins St Missoula MT 59801-3714 | |
| (406) 207-2246 | |
| Not Available |
| Full Name | King Family Behavioral Health |
|---|---|
| Speciality | Social Worker |
| Location | 839 Rollins St, Missoula, Montana |
| Authorized Official Name and Position | Matt King (OWNER) |
| Authorized Official Contact | 4062072246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| King Family Behavioral Health 839 Rollins St Missoula MT 59801-3714 Ph: (406) 207-2246 | King Family Behavioral Health 839 Rollins St Missoula MT 59801-3714 Ph: (406) 207-2246 |
| NPI Number | 1124806195 |
|---|---|
| Provider Enumeration Date | 09/20/2023 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 6406202050 |
|---|---|
| Medicare Enrollment ID | O20231102001366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124806195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer L Dodson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386369916 PECOS PAC ID: 0941656672 Enrollment ID: I20231130002991 |
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