SUNBURST COMMUNITY SERVICE FOUNDATION, INC (SUNBURST MENTAL HEALTH SERVICES) - NPI NUMBER 1083947055

Summary

Provider Name: SUNBURST COMMUNITY SERVICE FOUNDATION, INC (SUNBURST MENTAL HEALTH SERVICES)

NPI Number: 1083947055

Clasification: Clinic/Center (261QM0850X)

Specialization: Adult Mental Health

Address:
2282 US HIGHWAY 93 S
SUITE #1
KALISPELL, MT
ZIP 59901

Phone Number: (406) 745-3681



Detailed Information

SUNBURST COMMUNITY SERVICE FOUNDATION, INC is an adult mental health clinic/center in Kalispell, MT. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. The assigned NPI number for this provider is 1083947055 and is registered as an organization entity type.
The provider Is Doing Business As Sunburst Mental Health Services.

The provider's business address is:

2282 US HIGHWAY 93 S
SUITE #1
KALISPELL, MT
ZIP 59901-499
Phone: (406) 745-3681
Fax: (406) 745-3686

The provider's authorized official is Don Fleck .
The authorized official title is Administrative Director and has the following contact phone number (406) 745-3681.

The enumeration date for this NPI number is 9/9/2009 and was last updated on 5/8/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QM0850X Clinic/Center Adult Mental Health No
2 261QM0855X Clinic/Center Adolescent and Children Mental Health No
3 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) Yes

NPI Record

No. Field Name Field Value
1 NPI 1083947055
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name SUNBURST COMMUNITY SERVICE FOUNDATION, INC
5 Provider Other Organization Name SUNBURST MENTAL HEALTH SERVICES
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 2282 US HIGHWAY 93 S
8 Provider Second Line Business Practice Location Address SUITE #1
9 Provider Business Practice Location Address City Name KALISPELL
10 Provider Business Practice Location Address State Name MT
11 Provider Business Practice Location Address Postal Code 599018499
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 4067453681
14 Provider Business Practice Location Address Fax Number 4067453686
15 Provider Enumeration Date 9/9/2009
16 Last Update Date 5/8/2014
17 Authorized Official Last Name FLECK
18 Authorized Official First Name DON
19 Authorized Official Title or Position ADMINISTRATIVE DIRECTOR
20 Authorized Official Telephone Number 4067453681
21 Healthcare Provider Taxonomy Code 1 261QM0850X
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 261QM0855X
24 Healthcare Provider Primary Taxonomy Switch 2 N
25 Healthcare Provider Taxonomy Code 3 261QM0801X
26 Healthcare Provider Primary Taxonomy Switch 3 Y
27 Is Organization Subpart N

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.