| NPI | 1538413836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA RAFFAELE Billing Manager 406-727-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT 940) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-08 |