Provider Demographics
NPI:1043943236
Name:CALLIE MORRIS LLC
Entity type:Organization
Organization Name:CALLIE MORRIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:SWLC
Authorized Official - Phone:406-871-6876
Mailing Address - Street 1:725 W CENTRAL AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-6800
Mailing Address - Country:US
Mailing Address - Phone:406-871-6876
Mailing Address - Fax:
Practice Address - Street 1:725 W CENTRAL AVE STE 208
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6800
Practice Address - Country:US
Practice Address - Phone:406-871-6876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)