| NPI | 1528305604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY BROWN Administrative Assistant 406-857-2506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MT 2624) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OR 08R21) |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2013-01-10 |