| NPI | 1063981488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODETTE BOLANO President 208-367-4303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282J00000X Religious Nonmedical Health Care Institution |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |