| NPI | 1124794060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA MURPHY Medical Staff COO Rdinator 208-232-7862 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-08-20 |