| NPI | 1336392257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JUNE RUSSELL Owner 406-381-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: MT 0) |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2022-07-21 |