| NPI | 1285486837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MERLAINE CORNIE Director 208-404-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |