| NPI | 1316984529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON HOUSTON CFO 208-734-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 106H00000X Marriage & Family Therapist | |
| 122300000X Dentist | |
| 124Q00000X Dental Hygienist | |
| 133V00000X Dietitian, Registered | |
| 207Q00000X Family Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-04-30 |