| NPI | 1114770591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY EWALT Owner 406-249-9153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |