| NPI | 1023742533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSI SHELLY President 208-720-9670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2022-07-18 |