| NPI | 1386948453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORIN JACKLYN FISCH Owner/Partner 406-868-7832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MT 90518) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2017-01-11 |