Organization Name: | MONTANA SOCIETY INCORPORATED |
NPI Number: | 1023385390 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH CHANCE (CEO/PRESIDENT) |
Mailing Address: | 1630 Shoup St Prescott |
State: | AZ US |
Postal Code: | 863051343 |
Phone Number: | 9282272448 |
Fax Number: | 9282683433 |
NPI Enumeration Date: | 11/30/2011 |
NPI Last Update Date: | 07/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | BH3965 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |