| NPI | 1114335221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALAN JEPSON Owner 208-391-1043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: ID NP-902A) |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2015-02-03 |