| NPI | 1750759791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN MARIE GREEN Owner 406-586-9735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MT 8323) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MT 8323) |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |