| NPI | 1588921555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY A. JOHNSON Director 406-586-5493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MT 20113) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-04-16 |