| Southwest Chemical Dependency Program | |
|
430 E Park St Livingston MT 59047-2755 | |
| (406) 222-2812 | |
| (406) 222-4764 |
| Full Name | Southwest Chemical Dependency Program |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 430 E Park St, Livingston, Montana |
| Authorized Official Name and Position | Jean E. Mccauley (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4062222812 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Chemical Dependency Program Po Box 1587 Livingston MT 59047-5587 Ph: (406) 222-2812 | Southwest Chemical Dependency Program 430 E Park St Livingston MT 59047-2755 Ph: (406) 222-2812 |
| NPI Number | 1649300567 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 09/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649300567 | NPI | - | NPPES |
| 0320076 | Medicaid | MT | |
| 760140 | Other | MT | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | 089288 (Montana) | Primary |
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