| NPI | 1912032509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY BEASON MIS 406-234-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MT 273-07) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |