| NPI | 1013122563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI THROCKMORTON Agency Director 208-376-0191 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: ID 21136) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2008-06-04 |