| Phc Dba Friends of the Children Missoula | |
|
735 Michigan Ave Missoula MT 59802-5585 | |
| (406) 258-4789 | |
| (406) 258-4732 |
| Full Name | Phc Dba Friends of the Children Missoula |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 735 Michigan Ave, Missoula, Montana |
| Authorized Official Name and Position | Lara Salazar (CEO) |
| Authorized Official Contact | 4062583360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phc Dba Friends of the Children Missoula 401 Railroad St W Missoula MT 59802-4178 Ph: (406) 258-4496 | Phc Dba Friends of the Children Missoula 735 Michigan Ave Missoula MT 59802-5585 Ph: (406) 258-4789 |
| NPI Number | 1457173171 |
|---|---|
| Provider Enumeration Date | 10/25/2024 |
| Last Update Date | 02/21/2025 |
| Certification Date | 02/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457173171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | () | Primary |
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