| Extraordinary Distances | |
|
178 W Lyndale Ave Helena MT 59601-2822 | |
| (406) 443-2455 | |
| Not Available |
| Full Name | Extraordinary Distances |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 178 W Lyndale Ave, Helena, Montana |
| Authorized Official Name and Position | Erica H. Durham (PRINCIPAL) |
| Authorized Official Contact | 4064432455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Extraordinary Distances 178 W Lyndale Ave Helena MT 59601-2822 Ph: (406) 443-2455 | Extraordinary Distances 178 W Lyndale Ave Helena MT 59601-2822 Ph: (406) 443-2455 |
| NPI Number | 1841820669 |
|---|---|
| Provider Enumeration Date | 01/21/2020 |
| Last Update Date | 01/21/2020 |
| Certification Date | 01/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841820669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QR0800X | Clinic/center - Recovery Care | (* (Not Available)) | Secondary |
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