| NPI | 1093938599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ALDRICH Administrator 208-737-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2025-10-02 |