1922155209 NPI number — BITTERROOT VALLEY EDUCATION COOPERATIVE

Table of content: (NPI 1922155209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922155209 NPI number — BITTERROOT VALLEY EDUCATION COOPERATIVE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BITTERROOT VALLEY EDUCATION COOPERATIVE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922155209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 PARK ST
Provider Second Line Business Mailing Address:
PO BOX 187
Provider Business Mailing Address City Name:
STEVENSVILLE
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59870-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-777-2494
Provider Business Mailing Address Fax Number:
496-777-2495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PARK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STEVENSVILLE
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59870-2603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-777-2494
Provider Business Practice Location Address Fax Number:
496-777-2495
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
406-777-2494

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 165733 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 255663 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350795 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 740430 . This is a "MENTAL HEALTH CENTER" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 741140 . This is a "LCPC" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 256598 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 743470 . This is a "SOCIAL WORK" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 160498 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165724 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165750 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165784 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165737 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165763 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 502486 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165767 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 165776 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 503489 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 71625 . This is a "SOCIAL WORK" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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