| NPI | 1093761694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON HOUSTON CEO 208-734-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 122300000X Dentist |
| 124Q00000X Dental Hygienist | |
| 133V00000X Dietitian, Registered | |
| 207Q00000X Family Medicine | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-03-17 |