| NPI | 1104214618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER WILLS Owner/Psychiatrist 208-319-3513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID MD 12500) |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2023-02-03 |