Extraordinary Distances
Community/Behavioral Health in Helena, MT. Organization (NPI-2).
NPI number1841820669
StatusActive
Last updated in NPPESJan 21, 2020
Details
- NPI
- 1841820669
- Entity type
- Organization (NPI-2)
- Legal business name
- Extraordinary Distances
- Organization subpart
- No
- Enumeration date
- Jan 21, 2020
- Certification date
- Jan 21, 2020
- Last updated
- Jan 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 261QR0800X | Clinic/Center, Recovery Care | – | – |
Practice location
178 W Lyndale AveHelena, MT 59601-2822
Phone 406-443-2455
Mailing address
178 W Lyndale AveHelena, MT 59601-2822
Phone 406-443-2455
Authorized official
Erica H. Durham
Principal
4064432455
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