| NPI | 1164717112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN DIANE SAARIO Owner 208-878-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: ID 09) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2012-11-21 |