Provider Demographics
NPI:1528258720
Name:BULLHOOK COMMUNITY HEALTH CENTER, INC.
Entity type:Organization
Organization Name:BULLHOOK COMMUNITY HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROZAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:406-395-6919
Mailing Address - Street 1:521 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3649
Mailing Address - Country:US
Mailing Address - Phone:406-395-4305
Mailing Address - Fax:406-395-5643
Practice Address - Street 1:521 4TH ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3649
Practice Address - Country:US
Practice Address - Phone:406-395-4305
Practice Address - Fax:406-395-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 104100000X, 124Q00000X, 208D00000X, 1041C0700X, 261QR0405X, 363AM0700X, 363LF0000X, 1223G0001X, 101YM0800X, 101YA0400X, 261QF0400X
MT261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
613047800OtherDOL FECA
613047800OtherDOL FECA
MT271831Medicare Oscar/Certification