Provider Demographics
NPI:1811536105
Name:RISING PEAK ACADEMY
Entity type:Organization
Organization Name:RISING PEAK ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BREKKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-897-8900
Mailing Address - Street 1:2347 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-9236
Mailing Address - Country:US
Mailing Address - Phone:406-897-8900
Mailing Address - Fax:
Practice Address - Street 1:2347 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-9236
Practice Address - Country:US
Practice Address - Phone:406-897-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children