| NPI | 1811176092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY PANNELL Co Owner 406-889-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IL 233169) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |