| NPI | 1265892780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL BRASSFIELD Admin Assistant 208-736-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |