Provider First Line Business Practice Location Address:
1900 2ND AVE S
Provider Second Line Business Practice Location Address:
CENTER FOR MENTAL HEALTH/GREAT FALLS HIGH SCHOOL
Provider Business Practice Location Address City Name:
GREAT FALLS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59405-2704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-268-6340
Provider Business Practice Location Address Fax Number:
406-761-0554
Provider Enumeration Date:
07/21/2006