| NPI | 1902105620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY BIRNBAUM Executive Director 406-721-2704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MT 7001001) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |