| NPI | 1861875668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK FERRITER Member/Provider 406-461-6784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT SWP-LCSW-LIC-8872) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |