| NPI | 1144984873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA BATTS Contracting Manager 208-380-4978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2024-04-12 |