LAKE HOUSE – NPI #1306202163
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

LAKE HOUSE is a community based residential treatment facility located in POLSON, MT. NPPES has assigned the NPI number 1306202163 to LAKE HOUSE on January 11, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LAKE HOUSE” is a dba name, the actual legal business name for this organization is WESTERN MONTANA MENTAL HEALTH CENTER. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 8 years ago on Jan 25, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LAKE HOUSE below.

NPI Profile for
WESTERN MONTANA MENTAL HEALTH CENTER

NPI Number
1306202163
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WESTERN MONTANA MENTAL HEALTH CENTER
Doing Business As (dba): LAKE HOUSE
Primary location
7 13TH AVE EAST
POLSON, MT 59860
Phone: (406) 532-8400 Fax: (406) 543-9316
Mailing address
140 N RUSSELL ST
MISSOULA, MT 59801-1704
Phone: (406) 532-8400 Fax: (406) 224-4402
Organization Subpart
No
Authorized Official
JODI DALY
CEO
Phone: (406) 532-8400
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
MT 12652

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.