| NPI | 1174916969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE BILD Owner 208-336-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID 1338) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-03-18 |