| NPI | 1720735269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BAUM Owner 406-899-0364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2022-03-04 |