NPI | 1124571815 |
---|---|
Entity Type | Organization |
Authorized Contact | AARON J HOUSTON CEO 208-734-3312 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 101Y00000X Counselor |
103T00000X Psychologist | |
104100000X Social Worker | |
106H00000X Marriage & Family Therapist | |
122300000X Dentist | |
124Q00000X Dental Hygienist | |
175T00000X Peer Specialist | |
207Q00000X Family Medicine | |
251B00000X Case Management | |
251S00000X | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2016-07-28 |
Last Update Date | 2022-11-23 |