| NPI | 1497964290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD J WILSON Executive Director 406-442-9244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2022-07-21 |