| NPI | 1134320104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KINMOUTH Owner 208-667-8860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 0-134) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |