| NPI | 1275705410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT F BALDREE President 208-552-3050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: ID PSY377) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |