| NPI | 1902560923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY PETERSON Owner 406-781-4973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2022-02-09 |