| Red Mountain Center Pllc | |
|
125 W Granite St Ste 207 Butte MT 59701-9215 | |
| (406) 219-1336 | |
| Not Available |
| Full Name | Red Mountain Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 125 W Granite St Ste 207, Butte, Montana |
| Authorized Official Name and Position | Donald Louis Kronenberger (MANAGING MEMBER) |
| Authorized Official Contact | 4062191336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Mountain Center Pllc 125 W Granite St Ste 207 Butte MT 59701-9215 Ph: (406) 219-1336 | Red Mountain Center Pllc 125 W Granite St Ste 207 Butte MT 59701-9215 Ph: (406) 219-1336 |
| NPI Number | 1164103552 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/27/2023 |
| Certification Date | 07/27/2023 |
| Medicare PECOS PAC ID | 9436593381 |
|---|---|
| Medicare Enrollment ID | O20240219002067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164103552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Donald Louis Kronenberger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841984267 PECOS PAC ID: 1951745801 Enrollment ID: I20240219002361 |
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