| NPI | 1972371714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN CHALMERS CFO 406-258-4445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2023-12-12 |