| NPI | 1184484875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRADFORD HUNT Agent 208-761-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-25 |