| NPI | 1063655462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL R WHITE Owner/Cna 406-697-9069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MT 329574) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2009-04-14 |