| NPI | 1164849345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY MICHELLE PETERSEN Psychiatric Nurse Practitioner 406-532-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MT 25102) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |