| NPI | 1114227097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN OLEARY Agency Director 208-466-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |