| NPI | 1396577011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN BRIGGS Billing Manager 406-258-4789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |