| NPI | 1073811097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT BELNAP Owner 208-246-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID M7357) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2012-03-07 |