NPI | 1003345125 |
---|---|
Entity Type | Organization |
Authorized Contact | GRETA KELLS JERNBERG Owner 406-529-2712 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MT 21727) |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MT 21727) |
Enumeration Date | 2017-06-12 |
Last Update Date | 2022-07-21 |