| NPI | 1114649639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA BOLYARD Clinical Director 406-646-2470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2025-12-01 |