| NPI | 1043749237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA ROSE ANDERSON Owner/Lac 406-488-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2017-06-26 |