Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI Number | 1720709629 |
| LBN Legal business name | CHOICEPOINT MT LLC |
| Authorized official | RYAN KACZKA - (MBMR) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 09/08/2022 |
| Last updated | 10/14/2022 - About 4 years ago |
| Identifiers | n/a |
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