| NPI | 1518409846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA J STARR Owner 406-544-0432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X (Licence: MT 4994) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2018-05-08 |