| NPI | 1235562604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE C. HAHN Agency Director 208-786-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: ID 0-246) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID 26450) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |