| NPI | 1730659699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA LICCARDI Owner/Manager 406-407-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2024-10-08 |