Basic Information
| Provider Information | |||||||||
| NPI: | 1821126004 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIMROCK FOUNDATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 30374 | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591070374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062483175 | ||||||||
| FaxNumber: | 4062483821 | ||||||||
| Practice Location | |||||||||
| Address1: | 1231 N 29TH ST | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591010122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062483175 | ||||||||
| FaxNumber: | 4062483821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | KOSOVICH | ||||||||
| AuthorizedOfficialFirstName: | LENETTE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4062483175 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 13319 | MT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 104100000X | 13319 | MT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 13319 | MT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 106H00000X | 13319 | MT | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 251E00000X | 13319 | MT | N | Agencies | Home Health | 251S00000X | 13319 | MT | N | Agencies | Community/Behavioral Health | 363L00000X | 13317 | MT | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 261QR0405X | 10687 | MT | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
ID Information
| ID | Type | State | Issuer | Description | 0350659 | 05 | MT | MEDICAID | 0320151 | 05 | MT | MEDICAID |