| NPI | 1265621908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MELCHIORE Rendering Physician 208-967-4771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2025-01-07 |