NPI | 1013031707 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE ELAINE MOORE Administrator 208-524-0881 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 806911700) |
Enumeration Date | 2007-03-19 |
Last Update Date | 2020-08-22 |