| NPI | 1235826447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMI ECHI-ABOLI Billing Department Director 208-360-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |