Provider Demographics
NPI: | 1427003862 |
---|---|
Name: | AWARE INC |
Entity type: | Organization |
Organization Name: | AWARE INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BUSINESS OPERATIONS MGR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LESLIE |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | YORK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 406-563-8117 |
Mailing Address - Street 1: | 205 E PARK AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | ANACONDA |
Mailing Address - State: | MT |
Mailing Address - Zip Code: | 59711-2340 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-563-8117 |
Mailing Address - Fax: | 406-563-5956 |
Practice Address - Street 1: | 205 E PARK AVE |
Practice Address - Street 2: | |
Practice Address - City: | ANACONDA |
Practice Address - State: | MT |
Practice Address - Zip Code: | 59711-2340 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-563-8117 |
Practice Address - Fax: | 406-563-5956 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-24 |
Last Update Date: | 2025-04-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103K00000X, 251C00000X, 251S00000X, 253Z00000X, 261Q00000X, 261QM0801X, 261QM0850X, 261QM0855X, 261QR0405X, 310400000X, 320600000X, 320800000X, 322D00000X, 343900000X | ||
MT | 251B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Single Specialty | |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | Group - Multi-Specialty | |
No | 253Z00000X | Agencies | In Home Supportive Care | ||
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | ||
No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | ||
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MT | 0350812 | Medicaid | |
MT | 000744813 | Other | BCBS PRE-LIC'D PROFESSNLS |
MT | 0493119 | Medicaid | |
NM | NM600001 | Other | VALUEOPTIONS VENDOR ID |
MT | 0502299 | Medicaid | |
MT | 0047124 | Medicaid | |
MT | 0255374 | Medicaid | |
MT | 0290343 | Medicaid | |
MT | 0320255 | Medicaid | |
MT | 0320331 | Medicaid | |
MT | 690812 | Medicaid | |
NM | 92507255 | Medicaid | |
NM | B3373 | Medicaid |