NPI | 1144530718 |
---|---|
Entity Type | Organization |
Authorized Contact | TODD HURT Program Manager 208-455-7057 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
Enumeration Date | 2010-10-18 |
Last Update Date | 2010-10-18 |