| NPI | 1285725143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY A COX Executive Director 406-496-6018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2025-08-25 |