| NPI | 1073984019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF GREEN Owner 406-582-9306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2021-09-10 |