| Sub Rosa Therapy | |
|
1001 Oak St Ste 205 Bozeman MT 59715-8757 | |
| (406) 581-1138 | |
| Not Available |
| Full Name | Sub Rosa Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 1001 Oak St Ste 205, Bozeman, Montana |
| Authorized Official Name and Position | Ann Matney (OWNER) |
| Authorized Official Contact | 4065811138 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sub Rosa Therapy 1001 Oak St Ste 205 Bozeman MT 59715-8757 Ph: () - | Sub Rosa Therapy 1001 Oak St Ste 205 Bozeman MT 59715-8757 Ph: (406) 581-1138 |
| NPI Number | 1083382329 |
|---|---|
| Provider Enumeration Date | 09/01/2021 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Medicare PECOS PAC ID | 6901245489 |
|---|---|
| Medicare Enrollment ID | O20240416004392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083382329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn M Lloyd |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538425590 PECOS PAC ID: 1658653118 Enrollment ID: I20170724002115 |
| Provider Name | Ann Maurine Matney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326385733 PECOS PAC ID: 7719326297 Enrollment ID: I20240416004399 |
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