| NPI | 1841820669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA H. DURHAM Principal 406-443-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |