| NPI | 1518640093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY PANKO CEO 406-219-1302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-09-08 |