| NPI | 1316090707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL DOSSETT Program Manager 406-826-3689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MT 0010241-001) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2011-08-23 |