| NPI | 1336394394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRICIA STERLING Reimbursment Supervisor 208-323-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M-10117) |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2008-11-18 |