| NPI | 1205313806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN N CLARK Owner 406-595-3746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 30112) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MT 30112) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |