| NPI | 1093297764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN STOW Credentialing 406-381-4196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 104100000X Social Worker | |
| 175T00000X Peer Specialist | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 1041C0700X Social Worker Clinical | |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2024-11-04 |