| NPI | 1013062553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIN MERLIN NIELSON President 208-861-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 807087900) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: ID 807072400) |
| 251S00000X Community/Behavioral Health (Licence: ID v38051fn) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |