| NPI | 1912613571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE ANN JOHNSON Owner/Mbr 406-579-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2023-01-27 |