| Winds Of Change Mental Health Center | |
|
1120 Cedar St Missoula MT 59802-3911 | |
| (406) 543-1929 | |
| Not Available |
| Full Name | Winds Of Change Mental Health Center |
|---|---|
| Speciality | Case Management |
| Location | 1120 Cedar St, Missoula, Montana |
| Authorized Official Name and Position | Donna Rose Jennings (PRESIDENT) |
| Authorized Official Contact | 4065414673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Winds Of Change Mental Health Center 1120 Cedar St Missoula MT 59802-3911 Ph: (406) 543-1929 | Winds Of Change Mental Health Center 1120 Cedar St Missoula MT 59802-3911 Ph: (406) 543-1929 |
| NPI Number | 1558483206 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 12/06/2021 |
| Certification Date | 12/06/2021 |
| Medicare PECOS PAC ID | 5395070429 |
|---|---|
| Medicare Enrollment ID | O20190711003091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558483206 | NPI | - | NPPES |
| 0290819 | Medicaid | MT |
| Provider Name | Bruce T Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194716084 PECOS PAC ID: 5294706057 Enrollment ID: I20040804001009 |
| Provider Name | Donna Kay Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578867016 PECOS PAC ID: 3375713712 Enrollment ID: I20110823000458 |
| Provider Name | Tommie Lynn Perusich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194364091 PECOS PAC ID: 7113352014 Enrollment ID: I20200123001321 |
| Provider Name | May Victor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154953982 PECOS PAC ID: 5991112039 Enrollment ID: I20210407002296 |
| Provider Name | Nathaniel Brent Chapman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386303097 PECOS PAC ID: 0547626087 Enrollment ID: I20230525001338 |
| Provider Name | Erin Erven |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043978042 PECOS PAC ID: 9537526348 Enrollment ID: I20230609003035 |
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