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Organization

THE GYST HOUSE 2

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICTORIA J DAVENPORT LAC, LCPC (CLINICAL DIRECTOR)
(406) 590-5963
Entity
Organization

Contact information

Practice address
4404 4TH AVE N, GREAT FALLS, MT 59405-1401
(406) 590-5963
Mailing address
4404 4TH AVE N, GREAT FALLS, MT 59405-1401
(406) 590-5963
(406) 866-0888

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
09/09/2024
Last updated
09/09/2024
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