| NPI | 1386066074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK MCKENNA CEO 406-847-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MT 22) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MT 22) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |