| NPI | 1235475849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CRUZ Owner 208-346-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2013-03-14 |