| NPI | 1023146529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD L HURT Field Operatioins Manager 208-455-7057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |