| NPI | 1851906895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN STOW Credentialing Manager 406-291-0321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 291U00000X Clinical Medical Laboratory | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2025-11-19 |