| NPI | 1184997223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN LYNN-YAHR WATSON Owner 208-412-7846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 4253) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |