1922559053 NPI number — WE CARE BEHAVIORAL HEALTH LLC

Table of content: (NPI 1922559053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922559053 NPI number — WE CARE BEHAVIORAL HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WE CARE BEHAVIORAL HEALTH LLC
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:
1922559053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2809 GREAT NORTHERN LOOP STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MISSOULA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59808-1749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-370-4473
Provider Business Mailing Address Fax Number:
406-630-4002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2809 GREAT NORTHERN LOOP STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSOULA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59808-1749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-370-4473
Provider Business Practice Location Address Fax Number:
406-630-4002
Provider Enumeration Date:
10/24/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ST. CLAIR
Authorized Official First Name:
ALLEXENDRA
Authorized Official Middle Name:
I
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
406-546-2301

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0850X , with the licence number: C1021925-10400509 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1922559053 . This is a "PACIFIC SOURCE HEALTH PLANS" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 1922559053 . This is a "BLUE CROSS BLUE SHIELD OF MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 1922559053 . This is a "MONTANA AND MOUNTAIN HEALTH CO OP" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 1922559053 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1922559053 . This is a "UBH" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 1922559053 . This is a "AETNA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 1922559053 . This is a "HUMANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 1922559053 . This is a "FIRST CHOICE HEALTH NETWORK" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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