Provider Demographics
NPI:1154014843
Name:GREAT FALLS SCOTTISH RITE CHILDHOOD LANGUAGE DISORDERS CLINIC INC
Entity type:Organization
Organization Name:GREAT FALLS SCOTTISH RITE CHILDHOOD LANGUAGE DISORDERS CLINIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-727-1088
Mailing Address - Street 1:1304 13TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4611
Mailing Address - Country:US
Mailing Address - Phone:406-250-1459
Mailing Address - Fax:
Practice Address - Street 1:1304 13TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4611
Practice Address - Country:US
Practice Address - Phone:406-727-1088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty