NPI | 1629800313 |
---|---|
Doing Business As | PHC RUSSELL ELEMENTARY |
Entity Type | Organization |
Authorized Contact | LARA SALAZAR Billing Manager 406-258-3360 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2024-08-20 |
Last Update Date | 2025-03-03 |