| NPI | 1013191915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORALYN ALEXANDER Owner 208-734-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID np662) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID m6940) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2010-08-23 |