Provider Demographics
NPI:1992786784
Name:EASTERN MONTANA COMMUNITY MENTAL HEALTH CENTER
Entity type:Organization
Organization Name:EASTERN MONTANA COMMUNITY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF INFORMATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BEASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-234-0234
Mailing Address - Street 1:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-1530
Mailing Address - Country:US
Mailing Address - Phone:406-234-0234
Mailing Address - Fax:406-234-0235
Practice Address - Street 1:2508 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5000
Practice Address - Country:US
Practice Address - Phone:406-234-1687
Practice Address - Fax:406-234-1698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 1041C0700X, 251B00000X, 251S00000X, 261Q00000X, 261QR0405X, 320800000X, 363LP0808X
MT10392261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental IllnessGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0255527Medicaid
MT0290147Medicaid
MT0402142Medicaid
MT0320112Medicaid
MT75031OtherBS/BS PROVIDER #
MT0439212Medicaid
MT0502418Medicaid
MT0491470Medicaid
MT0402142Medicaid