NPI | 1033762992 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE BERGREN Owner 406-399-1757 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2019-07-19 |
Last Update Date | 2019-10-10 |