NPI | 1568710879 |
---|---|
Entity Type | Organization |
Authorized Contact | VIRGINIA T EADUS Co Owner 406-403-0830 |
Organization Subpart ? | No |
Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MT C209442-1114283) |
Enumeration Date | 2012-08-16 |
Last Update Date | 2012-08-16 |