Provider Demographics
NPI:1306544309
Name:ADVENTURE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ADVENTURE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GERMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:NP
Authorized Official - Phone:941-615-7961
Mailing Address - Street 1:PO BOX 6486
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-6486
Mailing Address - Country:US
Mailing Address - Phone:941-615-7961
Mailing Address - Fax:406-401-1406
Practice Address - Street 1:1601 2ND AVE N
Practice Address - Street 2:SUITE 450F
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3259
Practice Address - Country:US
Practice Address - Phone:406-201-5699
Practice Address - Fax:406-401-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty