| NPI | 1891463048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA KUNTZ CFO 406-500-2139 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2023-10-09 |