| NPI | 1275577827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONEVAN B NEIDER Owner 208-552-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-05-06 |