| NPI | 1194291609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PATRICK MAXWELL Clinical Director, Clinician 406-579-4984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |