| NPI | 1780011965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEE A GENGENBACHER Partner 406-219-8474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 4689) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |