| NPI | 1710679345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANDREW MARK CEO 406-665-4103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |