| NPI | 1902025067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE FALCON Business Manager 406-245-6539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 10890) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 10890) |
| 1041C0700X Social Worker, Clinical (Licence: MT 10890) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |