| NPI | 1871203828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY CANNON Therapist 406-319-5821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2023-02-26 |