Organization Name: | DISTRICT II ALCOHOL AND DRUG PROGRAM |
NPI Number: | 1144366246 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JERRY D SCHLEPP (EXECUTIVE DIRECTOR) |
Mailing Address: | 119 S Kendrick Ave Glendive |
State: | MT US |
Postal Code: | 593301626 |
Phone Number: | 4063775942 |
Fax Number: | 4063773050 |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 211-07 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |