| NPI | 1447835558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN R THOMPSON Owner/Nurse Practitioner 406-396-5764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-06-29 |