| NPI | 1194326462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTNI A FUNDERBURK Clinical Psychologist 406-799-1366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |