| NPI | 1134349103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BEASON MIS 406-234-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MT 10392) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |