| NPI | 1053521633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY JOHNSON Director 406-586-5493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MT 201) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-08-26 |