| NPI | 1316525603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN RANDALL FERGUSON Executive Director 406-544-4510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-03-30 |