| NPI | 1306202163 |
|---|---|
| Doing Business As | LAKE HOUSE |
| Entity Type | Organization |
| Authorized Contact | JODI DALY CEO 406-532-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MT 12652) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2018-01-25 |