| Dba Phc Russell Elementary | |
|
3216 S Russell St Missoula MT 59801-8537 | |
| (406) 370-0487 | |
| (406) 258-4732 |
| Full Name | Dba Phc Russell Elementary |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3216 S Russell St, Missoula, Montana |
| Authorized Official Name and Position | Lara Salazar (BILLING MANAGER) |
| Authorized Official Contact | 4062583360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Phc Russell Elementary 401 Railroad St W Missoula MT 59802-4178 Ph: (406) 258-4496 | Dba Phc Russell Elementary 3216 S Russell St Missoula MT 59801-8537 Ph: (406) 370-0487 |
| NPI Number | 1215769906 |
|---|---|
| Provider Enumeration Date | 08/20/2024 |
| Last Update Date | 02/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215769906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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