NPI | 1114058062 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES BRADFORD DANIELS Manager 208-949-3966 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2020-08-22 |