| NPI | 1013331545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BELL Owner 208-523-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID np-1180a) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ID lcsw-1103) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-04 |